Skipper Caleb, Abassi Mahsa, Boulware David R
Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
J Fungi (Basel). 2019 Jul 19;5(3):65. doi: 10.3390/jof5030065.
Cryptococcal meningitis persists as a significant source of morbidity and mortality in persons with HIV/AIDS, particularly in sub-Saharan Africa. Despite increasing access to antiretrovirals, persons presenting with advanced HIV disease remains common, and remains the most frequent etiology of adult meningitis. We performed a literature review and herein present the most up-to-date information on the diagnosis and management of cryptococcosis. Recent advances have dramatically improved the accessibility of timely and affordable diagnostics. The optimal initial antifungal management has been newly updated after the completion of a landmark clinical trial. Beyond antifungals, the control of intracranial pressure and mitigation of toxicities remain hallmarks of effective treatment. Cryptococcal meningitis continues to present challenging complications and continued research is needed.
隐球菌性脑膜炎仍然是艾滋病毒/艾滋病患者发病和死亡的重要原因，在撒哈拉以南非洲地区尤为如此。尽管获得抗逆转录病毒药物的机会有所增加，但患有晚期艾滋病的患者仍然很常见，并且仍然是成人脑膜炎最常见的病因。我们进行了文献综述，并在此介绍有关隐球菌病诊断和管理的最新信息。最近的进展极大地提高了及时且负担得起的诊断方法的可及性。在一项具有里程碑意义的临床试验完成后，最佳初始抗真菌治疗方案已得到新的更新。除了抗真菌药物外，控制颅内压和减轻毒性仍然是有效治疗的标志。隐球菌性脑膜炎继续带来具有挑战性的并发症，仍需要持续开展研究。
