Reframing the clinical phenotype and management of cryptococcal meningitis

TY - JOUR

T1 - Reframing the clinical phenotype and management of cryptococcal meningitis

AU - Rocha, Maria Francisca

AU - Bain, Hamish D C

AU - Stone, Neil

AU - Meya, David

AU - Darie, Lucia

AU - Toma, Ahmed K

AU - Lunn, Michael P T

AU - Mehta, Arpan R

AU - Coughlan, Charles

N1 - Publisher Copyright: © Author(s) 2024.

PY - 2024/7/12

Y1 - 2024/7/12

N2 - Cryptococcal meningitis is an important global health problem, resulting from infection with the yeast Cryptococcus, especially Cryptococcus neoformans and Cryptococcus gattii, which cause a spectrum of disease ranging from pulmonary and skin lesions to life-threatening central nervous system involvement. The diagnosis and management of cryptococcal meningitis have substantially changed in recent years. Cryptococcal meningitis often occurs in people living with advanced HIV infection, though in high-income countries with robust HIV detection and treatment programmes, it increasingly occurs in other groups, notably solid-organ transplant recipients, other immunosuppressed patients and even immunocompetent hosts. This review outlines the clinical presentation, management and prognosis of cryptococcal meningitis, including its salient differences in people living with HIV compared with HIV-negative patients. We discuss the importance of managing raised intracranial pressure and highlight the advantages of improved multidisciplinary team working involving neurologists, infectious disease specialists and neurosurgeons.

AB - Cryptococcal meningitis is an important global health problem, resulting from infection with the yeast Cryptococcus, especially Cryptococcus neoformans and Cryptococcus gattii, which cause a spectrum of disease ranging from pulmonary and skin lesions to life-threatening central nervous system involvement. The diagnosis and management of cryptococcal meningitis have substantially changed in recent years. Cryptococcal meningitis often occurs in people living with advanced HIV infection, though in high-income countries with robust HIV detection and treatment programmes, it increasingly occurs in other groups, notably solid-organ transplant recipients, other immunosuppressed patients and even immunocompetent hosts. This review outlines the clinical presentation, management and prognosis of cryptococcal meningitis, including its salient differences in people living with HIV compared with HIV-negative patients. We discuss the importance of managing raised intracranial pressure and highlight the advantages of improved multidisciplinary team working involving neurologists, infectious disease specialists and neurosurgeons.

UR - https://www.scopus.com/pages/publications/85199140328

U2 - 10.1136/pn-2024-004133

DO - 10.1136/pn-2024-004133

M3 - Review article

C2 - 38997136

SN - 1474-7758

JO - Practical Neurology

JF - Practical Neurology

ER -