Treatment principles for Candida and Cryptococcus.
The yeasts Candida and Cryptococcus spp. are important human opportunistic pathogens. Candida spp. rely on skin or mucosal breach to cause bloodstream infection, whereas Cryptococcus spp. exploit depressed cell-mediated immunity characteristic of advanced HIV infection. The treatment for both organisms relies on the administration of rapidly fungicidal agents. In candidaemia, source control is important, with removal of prosthetic material and drainage of collections, as well as hunting for and tailoring therapy to disseminated sites of infection, particularly the eyes and heart. For cryptococcal meningitis, restoration of immune function through antiretroviral therapy (ART) is key, together with careful management of the complications of raised intracranial pressure and relapsed infection, both pre- and post-ART.
Pharmacy Department, St George's Hospital NHS Trust, London SW17 0QT, United Kingdom.
Laura C
LC
Whitney
Infection and Immunity Research Institute, St George's University of London, London SW17 0RE, United Kingdom.
Tihana
T
Bicanic
D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001850:Bone Diseases, Infectious / Q000175:diagnosis / Q000188:drug therapy; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy*; D002494:Central Nervous System Infections / Q000175:diagnosis / Q000188:drug therapy; D002908:Chronic Disease; D060085:Coinfection / Q000188:drug therapy; D003453:Cryptococcosis / Q000175:diagnosis / Q000188:drug therapy*; D004696:Endocarditis / Q000175:diagnosis / Q000188:drug therapy; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D019586:Intracranial Hypertension / Q000517:prevention & control; D008826:Microbial Sensitivity Tests; D012008:Recurrence; D018570:Risk Assessment; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy
D044966:Anti-Retroviral Agents; D000935:Antifungal Agents