Mourad Ahmad, Perfect John R
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
J Fungi (Basel). 2018 Jul 3;4(3):79. doi: 10.3390/jof4030079.
Cryptococcal infections burden the immunocompromised population with unacceptably high morbidity and mortality. This population includes HIV-infected individuals and those undergoing organ transplants, as well as seemingly immunocompetent patients (non-HIV, non-transplant). These groups are difficult to manage with the current therapeutic options and strategies, particularly in resource-limited settings. New trials aimed at providing the best treatment strategies for resource-limited countries that will reduce costs and adverse reactions have focused on decreasing the length of therapy and using more readily accessible antifungal agents such as fluconazole. Furthermore, the emergence of antifungal resistance poses another challenge for successful treatment and may require the development of new agents for improved management. This review will discuss the principles of management, current and future antifungal agents, as well as emerging techniques and future directions of care for this deadly infection.
隐球菌感染给免疫功能低下人群带来了高得令人难以接受的发病率和死亡率。这一人群包括艾滋病毒感染者、接受器官移植者以及看似免疫功能正常的患者（非艾滋病毒感染者、非移植患者）。当前的治疗选择和策略对这些群体难以奏效，尤其是在资源有限的环境中。旨在为资源有限国家提供最佳治疗策略以降低成本和不良反应的新试验，重点在于缩短治疗时长以及使用更易获取的抗真菌药物，如氟康唑。此外，抗真菌耐药性的出现给成功治疗带来了另一挑战，可能需要研发新药物以改善治疗效果。本综述将讨论隐球菌感染的治疗原则、当前和未来的抗真菌药物，以及针对这种致命感染的新兴技术和未来护理方向。
