【3.2】2012年隐球菌性脑膜炎预防诊断及治疗.pdfVIP

Curr HIV/AIDS Rep (2012) 9:267–277 DOI 10.1007/s11904-012-0127-7 CO-INFECTIONS (C BENSON, SECTION EDITOR) New Insights in the Prevention, Diagnosis, and Treatment of Cryptococcal Meningitis Arthur Jackson Charles van der Horst Published online: 5 July 2012 # Springer Science+Business Media, LLC 2012 Abstract Cryptococcal meningitis (CM) remains a major syndromes in many African countries, accounting for 40 % cause of morbidity and mortality among immunocompro- of meningitis cases in Malawi [5]. mised patients, especially in areas of high HIV prevalence, although it can also cause disease in the apparently immu- nocompetent. Improving the management of HIV-associated Epidemiology CM is important to ensure that patients can survive to benefit from increasing access to ART. In this review we Cryptococcus neoformans is a ubiquitous environmental focus on recent advances in prevention, diagnosis, and treat- fungus found worldwide. The causative fungi for CM are ment of CM. divided into two separate species: C. neoformans and Cryp- tococcus gattii. C. neoformans variant grubii causes most Keywords Cryptococcus . Cryptococcal meningitis . disease among the severely immunocompromised and in the Meningitis . HIV . Immunocompromised . Prevention . developing world [6]. C. gattii has a greater tendency to Diagnosis . Treatment cause disease among apparently immunocompetent persons and has been the cause of an ongoing outbreak of CM in North America in the Pacific Northwest for over a decade [7, 8]. Introduction Cryptococci usually enter the body by inhalation of the infectious propagule