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Of the 491 LPs,90%were performed in white,93%in men,and 11%in injection drug users.Cerebrospinal fluid test results revealed secondary meningitis in 39(7.9%)of 491 LPs performed on 322 individuals.Cryptococcal meningitis was the predominant type(27 cases);no bacterial or tuberculous meningitis was found.In multivariate analyses,a history of non-Hodgkin's lymphoma (adjusted odds ratio[OR],4.3;95%confidence interval[CI],1.5 to 12.5),a history of herpes simplex virus infection(OR,2.5;95%CI,1.2 to 5),nausea and/or vomiting(OR,2.0;95%CI,1.03 to 4.0),headache in a person with the acquired immunodeficiency syndrome(OR,2.1;95%CI,1.8 to 14.1),were positive correlates of opportunistic meningitis;current fluconazole use(OR,0.3;95% CI,0.1 to 0.8)conferred a lower risk.In similar clinical settings, physicians and their human immunodeficiency virus-infected patients should consider these features when assessing the risk of secondary meningitis and the necessity for immediate LP. |
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