title: Epidemiology and management of cryptococcal meningitis: developments and challenges.
abstract: The significance of cryptococcal infection as a cause of human disease has dramatically evolved in recent years. The objective of this study was to outline the worldwide significance of cryptococcosis and review developments in the management of cryptococcal meningitis. Cryptococcus neoformans var. grubii remains an important cause of disease, particularly in hosts with acquired immunosuppression. Cryptococcus gattii, on the other hand, infects hosts with seemingly normal immune systems and a recent dramatic outbreak in a new ecologic environment highlights the emerging clinical significance of this fungal pathogen. The introduction of new antifungal agents and the adoption of strategies for controlling elevated intracranial pressure in cryptococcal meningitis have added to our therapeutic options. However, the mortality from this infection remains unacceptably high and we are faced with the specific challenges in the management of this disease.
authors.affiliation: Massachusetts General Hospital, Division of Infectious Diseases, 55 Fruit Street, Boston, MA 02114-2696, USA.
authors.forename: Read
authors.initials: R
authors.lastname: Pukkila-Worley
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Mylonakis
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003455:Cryptococcus neoformans / Q000472:pathogenicity*; D004334:Drug Administration Schedule; D006801:Humans; D006849:Hydrocephalus / Q000382:microbiology / Q000628:therapy*; D054019:Immune Reconstitution Inflammatory Syndrome / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D016919:Meningitis, Cryptococcal / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents