Cryptococcosis
Dromer, F.
La Revue du Praticien 51(7): 738-741
2001
ISSN/ISBN: 0035-2640 PMID: 11387669 Document Number: 534655
Cryptococcus neoformans, an encapsulated yeast is responsible for life-threatening infection in patients with cellular immune defect especially those with AIDS. The most frequent presentation of cryptococcosis is a disseminated meningoencephalitis without acute onset. The diagnosis is based on direct examination with India ink staining, detection of soluble capsular polysaccharide in body fluids, culture of the micro-organism or histology. Looking for other localisations and for factors of poor prognosis is mandatory before selecting the right treatment regimen. In case of meningitis, one should prefer a combination of amphotericin B and 5 fluorocytosin, followed by a triazole, usually fluconazole until sterilisation of all infected sites is achieved or even for life-time maintenance therapy in case of sustained immune defect.