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Updated: Nov 22, 2025
08:24
Size Matters: Measurement of Capsule Diameter in Cryptococcus neoformans
Published on: February 27, 2018
14.2K
Cryptococcal meningitis: a review for emergency clinicians
Kathryn Marie Fisher1, Tim Montrief2, Mark Ramzy2
1Department of Emergency Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
Internal and Emergency Medicine
|January 9, 2021
Summary
Cryptococcal meningitis (CM) requires prompt emergency department (ED) evaluation and management. Early diagnosis and empiric treatment are crucial for improving outcomes in patients with suspected CM.
Area of Science:
- Infectious Diseases
- Neurology
- Emergency Medicine
Background:
- Cryptococcal meningitis (CM) is a high-risk condition often requiring emergency department (ED) intervention.
- Patients may present with subacute symptoms, complicating early diagnosis.
Purpose of the Study:
- To provide an evidence-based summary of current data for the emergency medicine evaluation and management of CM.
- To guide clinicians in diagnosing and treating suspected CM in the ED.
Main Methods:
- This narrative review synthesizes current literature on CM evaluation and management in the ED.
- Focuses on diagnostic strategies, empiric treatment, and supportive care.
Main Results:
- Newer Cryptococcal antigen tests offer high sensitivity and specificity in serum and CSF.
- Empiric treatment should cover bacterial, fungal, and viral meningitis, including amphotericin B and flucytosine for presumed CM.
- Management includes resuscitation, ICP control, and supportive care; ART initiation is contraindicated in the ED due to IRIS risk.
Conclusions:
- CM, though rare, has significant morbidity and mortality.
- Rapid diagnosis and evaluation for complications are essential.
- Early infectious disease consultation and symptomatic care are imperative.
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