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Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body

Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body

Published on: January 11, 2018

Cryptococcal meningitis in AIDS.

Andrej Spec¹, William G Powderly¹

¹Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States.

Handbook of Clinical Neurology

|April 2, 2018

Summary

This summary is machine-generated.

Cryptococcal meningitis is a serious threat for people with HIV. Early diagnosis and a year-long treatment plan involving antifungals and careful management of complications like increased intracranial pressure are crucial for survival.

Keywords:

Africa amphotericin cryptococcal meningitis cryptococcus fluconazole flucytosine lymphocytic meningitis

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Area of Science:

Infectious Diseases
Neuroscience
Immunology

Background:

Cryptococcal meningitis is a leading cause of death in people with human immunodeficiency virus (HIV).
While decreasing in developed nations due to earlier HIV diagnosis, it remains prevalent, especially in resource-limited settings.
Typical symptoms include headache, fever, and sometimes cranial nerve deficits; space-occupying lesions are rare.

Purpose of the Study:

To outline current management strategies for cryptococcal meningitis in HIV-infected patients.
To emphasize the importance of timely and appropriate antifungal therapy and management of complications.
To address the nuances of immune reconstitution inflammatory syndrome (IRIS) and steroid use.

Main Methods:

Review of established treatment protocols for cryptococcal meningitis.
Discussion of diagnostic criteria and presenting symptoms.
Guidance on managing elevated intracranial pressure and IRIS.

Main Results:

Recommended treatment involves initial amphotericin B plus flucytosine, followed by fluconazole for at least one year or until CD4 count exceeds 100 cells/μL.
Aggressive management of increased opening pressure with lumbar punctures or neurosurgical interventions is necessary.
Delaying antiretroviral therapy for 2-10 weeks post-antifungal initiation is advised to prevent IRIS, though IRIS management involves supportive care and anti-inflammatories, not antiretroviral interruption.

Conclusions:

Effective management of cryptococcal meningitis requires a multi-faceted approach including potent antifungal therapy, vigilant monitoring of intracranial pressure, and strategic timing of antiretroviral therapy.
Immune reconstitution inflammatory syndrome (IRIS) requires careful management with anti-inflammatories and supportive care, and steroids should be used judiciously.
Optimal treatment outcomes depend on adherence to therapeutic guidelines and prompt management of associated complications to reduce morbidity and mortality.