Kirchner J T
Department of Family and Community Medicine, Lancaster General Hospital, PA 17603, USA.
Postgrad Med. 1996 Jun;99(6):209-16.
Both cryptococcosis and histoplasmosis are life-threatening diseases in patients with advanced HIV infection. Cryptococcal disease in patients with AIDS is usually a systemic illness with an insidious onset of meningoencephalitis. Development of potent oral antifungal agents has simplified therapy, although patients with cryptococcal meningitis are at high risk for relapse. Histoplasmosis is usually disseminated in AIDS patients. Definitive diagnosis requires culture of the pathogen from blood or other specimens. Although availability of azole compounds has broadened treatment options, relapse is common after treatment of acute disease, and lifelong suppressive oral therapy is needed. Antifungal prophylaxis is not considered cost-effective at this time.
隐球菌病和组织胞浆菌病对于晚期HIV感染患者而言均为危及生命的疾病。艾滋病患者的隐球菌病通常是一种全身性疾病，隐匿性起病，可发展为脑膜脑炎。强效口服抗真菌药物的出现简化了治疗，尽管隐球菌性脑膜炎患者有很高的复发风险。组织胞浆菌病在艾滋病患者中通常呈播散性。明确诊断需要从血液或其他标本中培养出病原体。尽管唑类化合物的应用拓宽了治疗选择，但急性疾病治疗后复发很常见，需要终身口服抑制性治疗。目前抗真菌预防不被认为具有成本效益。
