Cryptococcosis is an infection caused by inhaling the fungus Cryptococcus neoformans. The infection commonly starts following inhalation of the organism. Most cases occur in people whose resistance to infection is lowered. Cryptococcus is one of the most common life-threatening fungal infections in AIDS patients. Cryptococcosis is an opportunistic infection that puts people with immune system diseases at higher risk of developing more serious forms of the disease. In the United States, 6-10% of all patients with aids get cryptococcosis. Cryptococcus gattii causes infections in immunocompetent people.
People who have defects in their cell-mediated immunity, for example, people with AIDS, are especially susceptible to disseminated cryptococcosis. People with a functioning immune system who have Cryptococcus in only a small part of their lungs usually do not require any treatment. Drugs used to treat people with a weakened immune system include fluconazole. Flucytosine is unreliable if used alone, and resistance develops rapidly; in cryptococcal disease, administer this drug in conjunction with amphotericin B. Do not use currently available azoles (ketoconazole and itraconazole) in the initial treatment of disseminated or CNS cryptococcal disease. Minimize doses of corticosteroid medications.
Safer practices reduce the risk of acquiring HIV. AIDS patients often have a reduced response to Amphotericin B and flucytosine, therefore after initial treatment as above, oral fluconazole can be used. Amphotericin B desoxycholate is the DOC for initial therapy of cryptococcal infection. This drug has a faster onset of action than fluconazole. A new oral solution of itraconazole is available and has improved bioavailability compared with the capsules. Amphotericin B desoxycholate is the DOC for initial therapy of cryptococcal infection. This drug has a faster onset of action than fluconazole. Lipid preparations of amphotericin B are very expensive and, although less nephrotoxic, are not more effective.
Cryptococcosis – Prevention and Treatment Tips:
1. Minimize doses of corticosteroid medications.
2. Safer practices reduce the risk of acquiring HIV .
3. Amphotericin B desoxycholate is the DOC for initial therapy of cryptococcal infection.
4. Lipid preparations of amphotericin B are very expensive.
5. Do not use currently available azoles in the initial treatment of disseminated.
6. Fluconazole is a bis-triazole that differs from other azoles by the substitution of a triazole group for the imidazole group.
