Cryptococcosis in immunocompromised patients without HIV infection: experience of a hospital in Chile.

BACKGROUND: Cryptococcus neoformans infection has traditionally been associated with HIV infection. However, its incidence has increased among individuals immunocompromised due to other causes. In Chile, data on cryptococcosis in this population are limited. AIMS: To determine the clinical, diagnostic, and treatment options in a group of immunocompromised patients suffering from cryptococcosis and without HIV infection. METHODS: A retrospective, observational study was conducted at Hospital del Salvador, Santiago de Chile. Patients diagnosed with cryptococcosis between 2016 and 2025 were included. RESULTS: A total of 31 patients with cryptococcosis were identified, of whom seven were HIV-negative. In this last subgroup, the median age was 58 years, and all patients had one or more comorbidities associated with immunosuppression. Additionally, three patients had oncohematological diseases, one patient was undergoing chemotherapy, and one patient had Rosai-Dorfman disease and was receiving high-dose corticosteroid therapy. Other three patients were recipients of solid organ transplants (SOT). Overall, six patients were corticosteroid users. All patients had fever. Cryptococcal meningitis was confirmed in five cases and extraneurological involvement in four. The 30-day mortality rate related to cryptococcosis was 28.6%. CONCLUSIONS: In the present study, cryptococcosis in individuals without HIV infection was an infrequent event, occurring primarily in patients with hematologic malignancies and SOT. The disease was associated with high morbidity, multisystem involvement, and elevated case fatality.