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Pulmonary Cryptococcosis
Pulmonary cryptococcosis describes an invasive lung mycosis caused by Cryptococcus neoformans or Cryptococcus gattii complex. It is often a high-consequence disease in both immunocompromised and immunocompetent populations, and may be misdiagnosed as pulmonary malignancy, leading to a delay in thera...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9696922/ https://www.ncbi.nlm.nih.gov/pubmed/36354923 http://dx.doi.org/10.3390/jof8111156 |
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author | Howard-Jones, Annaleise R. Sparks, Rebecca Pham, David Halliday, Catriona Beardsley, Justin Chen, Sharon C.-A. |
author_facet | Howard-Jones, Annaleise R. Sparks, Rebecca Pham, David Halliday, Catriona Beardsley, Justin Chen, Sharon C.-A. |
author_sort | Howard-Jones, Annaleise R. |
collection | PubMed |
description | Pulmonary cryptococcosis describes an invasive lung mycosis caused by Cryptococcus neoformans or Cryptococcus gattii complex. It is often a high-consequence disease in both immunocompromised and immunocompetent populations, and may be misdiagnosed as pulmonary malignancy, leading to a delay in therapy. Epidemiology follows that of cryptococcal meningoencephalitis, with C. gattii infection more common in certain geographic regions. Diagnostic tools include histopathology, microscopy and culture, and the detection of cryptococcal polysaccharide antigen or Cryptococcus-derived nucleic acids. All patients with lung cryptococcosis should have a lumbar puncture and cerebral imaging to exclude central nervous system disease. Radiology is key, both as an adjunct to laboratory testing and as the initial means of detection in asymptomatic patients or those with non-specific symptoms. Pulmonary cryptococcomas (single or multiple) may also be associated with disseminated disease and/or cryptococcal meningitis, requiring prolonged treatment regimens. Optimal management for severe disease requires extended induction (amphotericin B and flucytosine) and consolidation therapy (fluconazole) with close clinical monitoring. Susceptibility testing is of value for epidemiology and in regions where relatively high minimum inhibitory concentrations to azoles (particularly fluconazole) have been noted. Novel diagnostic tools and therapeutic agents promise to improve the detection and treatment of cryptococcosis, particularly in low-income settings where the disease burden is high. |
format | Online Article Text |
id | pubmed-9696922 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96969222022-11-26 Pulmonary Cryptococcosis Howard-Jones, Annaleise R. Sparks, Rebecca Pham, David Halliday, Catriona Beardsley, Justin Chen, Sharon C.-A. J Fungi (Basel) Review Pulmonary cryptococcosis describes an invasive lung mycosis caused by Cryptococcus neoformans or Cryptococcus gattii complex. It is often a high-consequence disease in both immunocompromised and immunocompetent populations, and may be misdiagnosed as pulmonary malignancy, leading to a delay in therapy. Epidemiology follows that of cryptococcal meningoencephalitis, with C. gattii infection more common in certain geographic regions. Diagnostic tools include histopathology, microscopy and culture, and the detection of cryptococcal polysaccharide antigen or Cryptococcus-derived nucleic acids. All patients with lung cryptococcosis should have a lumbar puncture and cerebral imaging to exclude central nervous system disease. Radiology is key, both as an adjunct to laboratory testing and as the initial means of detection in asymptomatic patients or those with non-specific symptoms. Pulmonary cryptococcomas (single or multiple) may also be associated with disseminated disease and/or cryptococcal meningitis, requiring prolonged treatment regimens. Optimal management for severe disease requires extended induction (amphotericin B and flucytosine) and consolidation therapy (fluconazole) with close clinical monitoring. Susceptibility testing is of value for epidemiology and in regions where relatively high minimum inhibitory concentrations to azoles (particularly fluconazole) have been noted. Novel diagnostic tools and therapeutic agents promise to improve the detection and treatment of cryptococcosis, particularly in low-income settings where the disease burden is high. MDPI 2022-10-31 /pmc/articles/PMC9696922/ /pubmed/36354923 http://dx.doi.org/10.3390/jof8111156 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Howard-Jones, Annaleise R. Sparks, Rebecca Pham, David Halliday, Catriona Beardsley, Justin Chen, Sharon C.-A. Pulmonary Cryptococcosis |
title | Pulmonary Cryptococcosis |
title_full | Pulmonary Cryptococcosis |
title_fullStr | Pulmonary Cryptococcosis |
title_full_unstemmed | Pulmonary Cryptococcosis |
title_short | Pulmonary Cryptococcosis |
title_sort | pulmonary cryptococcosis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9696922/ https://www.ncbi.nlm.nih.gov/pubmed/36354923 http://dx.doi.org/10.3390/jof8111156 |
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