[Cryptococcosis].
Cryptococcus neoformans, an encapsulated yeast is responsible for life-threatening infection in patients with cellular immune defect especially those with AIDS. The most frequent presentation of cryptococcosis is a disseminated meningoencephalitis without acute onset. The diagnosis is based on direct examination with India ink staining, detection of soluble capsular polysaccharide in body fluids, culture of the micro-organism or histology. Looking for other localisations and for factors of poor prognosis is mandatory before selecting the right treatment regimen. In case of meningitis, one should prefer a combination of amphotericin B and 5 fluorocytosin, followed by a triazole, usually fluconazole until sterilisation of all infected sites is achieved or even for life-time maintenance therapy in case of sustained immune defect.
Dromer
F
F
Unité de mycologie Centre national de référence des mycoses humaines et des antifongiques Institut Pasteur 75724 Paris 15. dromer@pasteur.fr
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D003453:Cryptococcosis / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005437:Flucytosine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000628:therapy; D009172:Mycology / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
D000935:Antifungal Agents; D000666:Amphotericin B; D005437:Flucytosine