Treatment of cryptococcosis in non-HIV immunocompromised patients.

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 t...

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Publicado en:Current Opinion in Infectious Diseases Vol. 31; no. 4; pp. 278 - 286
Autores principales: Henao-Martínez, Andrés F., Chastain, Daniel B., Franco-Paredesa, Carlos, Franco-Paredes, Carlos
Formato: review tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Treatment of cryptococcosis in non-HIV immunocompromised patients.
      aug:
        au:
          Henao-Martínez, Andrés F.
          Chastain, Daniel B.
          Franco-Paredesa, Carlos
          Franco-Paredes, Carlos
        affil: Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, Aurora, Colorado
      sug:
        subj:
          Cryptococcosis Therapy
          Cryptococcus Immunology
          Cryptococcosis Etiology
          Immunocompromised Host
          Recurrence
          Cryptococcosis Diagnosis
          Meningitis, Cryptococcal Therapy
          Meningitis, Cryptococcal Etiology
          Antifungal Agents Therapeutic Use
          Antifungal Agents Adverse Effects
          Meningitis, Cryptococcal Diagnosis
          Cryptococcosis Prevention and Control
          Antifungal Agents Administration and Dosage
      ab: 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.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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