Cryptococcal meningitis : epidemiology and therapeutic options
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Cryptococcal meningitis causes morbidity and mortality worldwide. The burden of disease is greatest in middle- and low-income countries with a high incidence of human immunodeficiency virus (HIV infection. Patients taking immunosuppressive drugs and some immunocompetent hosts are also at risk. Treatment of cryptococcal meningitis consists of three phases: Induction, consolidation, and maintenance. Effective induction therapy requires potent fungicidal drugs (amphotericin B and flucytosine, which are often unavailable in low-resource, high-endemicity settings. As a consequence, mortality is unacceptably high. Wider access to effective treatment is urgently required to improve outcomes. For human immunodeficiency virus-infected patients, judicious management of asymptomatic cryptococcal antigenemia and appropriately timed introduction of antiretroviral therapy are important.
Sloan , D J & Parris , V 2014 , ' Cryptococcal meningitis : epidemiology and therapeutic options ' Journal of Clinical Epidemiology , vol 6 , pp. 169-182 . DOI: 10.2147/CLEP.S38850
Journal of Clinical Epidemiology
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