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Cryptococcosis

Adela S. Magallanes, MD and Munima Nasir, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Major invasive fungal infection, caused by encapsulated yeasts

  • There are >30 different species of Cryptococcus. Two species cause nearly all cryptococcal disease in humans—Cryptoco...

DIAGNOSIS

HISTORY

  • Cryptococcal meningitis

    • Insidious onset, subtle findings such as impaired mentation, lethargy, or memory loss in immunosuppressed patients

    • Immunocompetent patients may have fluctuatin...

TREATMENT

MEDICATION

  • Treat based on immune status and disease stage.

  • Treat Cryptococcus prior to initiating HAART therapy in HIV-infected patients to avoid immune reconstitution inflammatory syndrome (I...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • In immunosuppressed patients with cryptococcal meningitis, lifelong secondary prophylaxis is generally required for suppression:

    • Without suppre...

REFERENCES

1
Maziarz E, Perfect J. Cryptococosis. Infect Dis Clin North Am.  2016;30(1):179–206. [View Abstract on OvidMedline]
2
Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelin...

ADDITIONAL READING

  • Gullo FP, Rossi SA, Sardi Jde C, et al. Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment. Eur J Clin Microbiol Infect Dis.  2013;32(11):1377–...

SEE ALSO

HIV/AIDS 

CODES

ICD10

  • B45.9 Cryptococcosis, unspecified

  • B45.1 Cerebral cryptococcosis

  • B45.0 Pulmonary cryptococcosis

  • B45.2 Cutaneous cryptococcosis

  • B45.3 Osseous cryptococcosis

  • B45.7 Disseminated cryptococcosis

  • B45.8 ...

CLINICAL PEARLS

  • Cryptococcal meningitis is not spread from person to person.

  • Skin nodules imply disseminated disease. When discovered, look for CNS and pulmonary involvement and treat accordingly.

  • Up to...

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