Clinical Characteristics and Risk Factors for Cryptococcal Meningitis in Non-Acquired Immunodeficiency Syndrome Patients with Pulmonary Cryptococcosis: A 12-Year Hospital-Based Study

In this study, we aimed to investigate the clinical characteristics of pulmonary cryptococcosis (PC) patients without acquired immunodeficiency disease (AIDS). In this retrospective study, a total of 101 patients with non-AIDS PC diagnosed at Tangdu Hospital between January 2014 and October 2025 were enrolled. The characteristics of demographic data, underlying diseases, clinical manifestations, laboratory indicators, and clinical outcomes were analyzed. Univariate and multivariate logistic regression analyses were used to identify risk factors for cryptococcal meningitis (CM). Among 101 patients (mean age 53.13 ± 12.31 years; 66.3% male), 56.4% were asymptomatic. Underlying diseases were present in 55.4% (mainly hypertension and diabetes), and CM occurred in 17.8% (18/101). Patients with CM had a higher proportion of underlying diseases (83.3% vs. 49.4%) and lower levels of red blood cells, hemoglobin, total protein, albumin, globulin, and potassium. Multivariate analysis revealed underlying diseases (OR = 7.246, 95% CI: 1.426~55.33), hypoglobulinemia (OR = 0.847, 95% CI: 0.734~0.956), and hypokalemia (OR = 0.177, 95% CI: 0.028~0.778) as independent risk factors for CM. The combined model showed good predictive value (AUC = 0.863). Non-AIDS PC often presents asymptomatically. Patients with underlying diseases, hypoglobulinemia, or hypokalemia are at significantly higher risk for concurrent CM and warrant aggressive central nervous system evaluation.