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Cryptococcosis

Munima Nasir, MD and Seth L Martin, MD Reviewed 05/2023
 


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 fluctuating ...

TREATMENT

MEDICATION

  • Treat based on immune status and disease stage.

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

First Line

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

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

    • Without suppress...

REFERENCES

1
Gushiken AC, Saharia KK, Baddley JW. Cryptococcus. Infect Dis Clin N Am. 2021;35:493–514.
2
Rajasingham R, Smith RM, Park BJ, et al. Global burden of disease of HIV-associated cryptococcal m...

ADDITIONAL READING

  • Boulware DR, Meya DB, Muzoora C, et al; for COAT Trial Team. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med. 2014;370...

SEE ALSO

HIV/AIDS 

CODES

ICD10

  • B45.1 Cerebral cryptococcosis

  • B45 Cryptococcosis

  • B45.7 Disseminated cryptococcosis

  • B45.0 Pulmonary cryptococcosis

  • B45.3 Osseous cryptococcosis

  • B45.8 Other forms of cryptococcosis

  • B45.2 Cutaneous ...

CLINICAL PEARLS

  • Cryptococcal meningitis is not spread from person to person.

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

  • Up to...

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