Neuroimaging findings of disseminated cryptococcosis in children and correlation with prognosis.

BACKGROUND

Disseminated cryptococcosis is a rare and fatal disease involving the central nervous system (CNS) that often presents with severe clinical symptoms and a poor prognosis.

OBJECTIVE

To describe the neuroimaging findings of disseminated cryptococcosis in children and investigate their correlation with patients' prognosis.

MATERIALS AND METHODS

The information of hospitalized patients with disseminated cryptococcosis was collected between January 2012 and December 2023. The study comprehensively evaluated clinical manifestations, laboratory tests, imaging findings, and long-term outcomes.

RESULTS

Forty cases of disseminated cryptococcosis were identified; headache was more common in patients with CNS involvement than in those without (P < 0.05). The most commonly affected organs were the lungs (n = 38; 92.5%), lymph nodes (n = 30; 75.0%), and CNS (n = 23; 57.5%). Among the 19 patients with CNS involvement, 11 (57.9%) had parenchymal lesions, and three (15.8%) showed restricted diffusion. Seven patients (50.0%) showed parenchymal enhancing lesions, and six patients (42.9%) showed leptomeningeal enhancement. Seizures (P = 0.022), parenchymal findings (P = 0.036), and lesions with enhancement (P = 0.019) were associated with poor outcomes, whereas lymph node involvement (P = 0.017) was associated with good outcomes.

CONCLUSION

Neuroimaging manifestations of disseminated cryptococcosis with CNS involvement frequently include brain parenchymal lesions. Furthermore, patients presenting with brain parenchymal lesions or seizures often have poor outcomes; therefore, early detection and intervention are imperative to improve patient prognosis.