医学
隐球菌病
氟康唑
重症监护医学
人口
疾病
免疫学
入射(几何)
机会性感染
抗真菌
两性霉素B
隐球菌
脑膜炎
人类免疫缺陷病毒(HIV)
隐球菌性脑膜炎
内科学
儿科
病毒性疾病
环境卫生
皮肤病科
物理
光学
微生物学
生物
作者
Andrés F. Henao‐Martínez,Daniel B. Chastain,Carlos Franco‐Paredes
标识
DOI:10.1097/qco.0000000000000458
摘要
PURPOSE OF REVIEW: Cryptococcosis has become a common opportunistic infection among non-HIV immunocompromised hosts. Recent reports have shown the incidence of Cryptococcosis among HIV-negative immunocompromised patients reaches close to half of the overall cases reported in the USA. Management of this infection in this population carries unique challenges. We aim to review relevant and recent research findings to develop treatment recommendations for this type of population. RECENT FINDINGS: Most of the recommendations for the management of non-HIV immunocompromised host are extrapolated from HIV studies. Cryptococcosis among non-HIV patients is common but often overlooked. Some clinical factors, when present, may increase the risk of Cryptococcosis among HIV-negative patients and appropriate screening and assessment for the disease is necessary. Treating clinicians should consider a longer duration of induction with Amphotericin B depending on the type of host, immunocompromised state, antifungal response and presence of neurological complications. Baseline fluconazole resistance can reach up to 12%, which is an important consideration for cryptococcal meningitis relapses or suboptimal responses to therapy. SUMMARY: Cryptococcus spp. conveys a high disease burden among immunocompromised hosts. Clinicians must consider numerous variables and factors in a dynamic way to offer the best possible treatment and to monitor their response to therapy. Due to the high cost and associated toxicities, we still need new affordable therapies and studies among non-HIV immunocompromised patients.
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