Abstract: Objective The aim was to summarize the clinical characteristics of patients with pulmonary and extrapulmonary cryptococcal infection and analyze the independent risk factors of extrapulmonary cryptococcal infection.Methods Data of inpatients with cryptococcal disease who were admitted in Beijing Chaoyang Hospital, Capital Medical University from January 2014 to December 2019, including clinical data, clinical manifestations, laboratory examination, diagnosis, therapy and prognosis were analyzed. According to the prognosis, the patients were divided into pulmonary cryptococcosis group (PC group) and extrapulmonary cryptococcosis group (EPC group). The data of the two groups were analyzed by statistical method. The multivariable Logistic regression analysis was used for risk factors of extrapulmonary infection. Results A total of 51 cases, 30 males and 21 females, with the median age of 55(40, 64) years, were collected. Totally 39 cases were complicated with basic disease. There were 41 cases in PC group and 10 in EPC group. The proportion of solid organ transplantation and chronic liver disease(40.0% and 40.0%) in EPC group was higher than that in PC group(7.3% and 7.3%), the difference was statistically significant (P<0.05). The incidence of headache in patients with EPC group(50.0%) was higher than that in PC group (2.4%), the difference was statistically significant(P<0.05). The levels of procalcitonin, aspartate transferase and creatinine in EPC group were higher than those in PC group, the difference was statistically significant(P<0.05). Albumin, peripheral blood CD4⁺ T cells and peripheral blood CD8⁺ T cells in EPC group were lower than those in PC group, the difference was statistically significant(P<0.05). The mortality rate of EPC group (60.0%) was higher than that of PC group (2.4%), the difference was statistically significant(P<0.05). Multivariable Logistic regression analysis showed that solid organ transplantation(OR=10.470, 95%CI:1.089-100.651, P=0.042) and lower serum albumin (OR=0.783, 95%CI:0.637-0.962, P=0.020) were independent risk factors for extrapulmonary infection. Conclusion The prognosis of patients with extrapulmonary cryptococcal infection is worse than that of patients with pulmonary cryptococcal infection. Solid organ transplantation and low albumin are independent risk factors for extrapulmonary cryptococcal infection

Key words: cryptococcus, pulmonary cryptococcosis, extrapulmonary cryptococcosis, organ transplantation