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  • 标题:Recent advances in management of cryptococcal meningitis: commentary
  • 本地全文:下载
  • 作者:Tania C Sorrell ; Sharon C-A Chen
  • 期刊名称:F1000 Biology Reports
  • 电子版ISSN:2051-7599
  • 出版年度:2010
  • 卷号:2
  • DOI:10.3410/M2-82
  • 语种:English
  • 出版社:Faculty of 1000 Ltd
  • 摘要:Cryptococcal meningitis remains a substantial health burden with high morbidity, particularly in developing countries. Antifungal treatment regimens are guided by host factors, severity of illness (including presence of complications), and causative cryptococcal species. Recent clinical studies indicate the need for rapidly fungicidal induction therapy regimens using amphotericin B in combination with flucytosine for optimal outcomes. Maintenance therapy with fluconazole is necessary until recovery of immune function. Cryptococcus gattii meningitis requires prolonged induction/eradication therapy. Prompt control of raised intracranial pressure or hydrocephalus is essential. Clinicians should be vigilant for immune restoration-like features. Adjuvant surgery, corticosteroids, and/or recombinant interferon-gamma may be required for large cryptococcomas, cerebral edema, or refractory infection.
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