Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america.
Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america.
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DOI：
10.1086/649858
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发表时间：
2010-02-01
期刊：
影响因子：
--
通讯作者：
Sorrell TC
中科院分区：
文献类型：
--
作者：
Perfect JR;Dismukes WE;Dromer F;Goldman DL;Graybill JR;Hamill RJ;Harrison TS;Larsen RA;Lortholary O;Nguyen MH;Pappas PG;Powderly WG;Singh N;Sobel JD;Sorrell TC
隐球菌病是一种全球性的侵袭性真菌病，具有显著的发病率和死亡率。这些管理指南是建立在2000年美国传染病学会指南的基础上的，并包括新的章节。讨论了3个风险组隐球菌脑膜脑炎的管理：（1）人类免疫缺陷病毒（HIV）感染者，（2）器官移植受者，（3）非HIV感染和非移植宿主。对于其他特殊风险人群，如儿童、孕妇、资源有限环境中的人以及感染隐球菌的人，也有具体的建议。管理建议还包括其他感染部位，包括肺隐球菌病的策略。隐球菌感染的潜在并发症，包括颅内压增高、免疫重建炎症综合征（IRIS）、耐药性和隐球菌瘤，一直是隐球菌感染治疗的重点。已经阐明了三个关键的管理原则：（1）使用杀真菌方案（如多烯和氟胞嘧啶）诱导治疗脑膜脑炎，随后使用氟康唑进行抑制方案;（2）早期识别和治疗颅内压升高和/或IRIS的重要性;（3）肾损害患者使用阿替霉素B脂质制剂方案。隐球菌病仍然是一个具有挑战性的管理问题，几乎没有新药开发或最近的明确研究。然而，如果早期诊断，如果临床医生坚持这些指南的基本原则，如果基础疾病得到控制，那么隐球菌病可以在绝大多数患者中成功管理。
Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. These guidelines for its management have been built on the previous Infectious Diseases Society of America guidelines from 2000 and include new sections. There is a discussion of the management of cryptococcal meningoencephalitis in 3 risk groups: (1) human immunodeficiency virus (HIV)–infected individuals, (2) organ transplant recipients, and (3) non–HIV-infected and nontransplant hosts. There are specific recommendations for other unique risk populations, such as children, pregnant women, persons in resource-limited environments, and those with Cryptococcus gattii infection. Recommendations for management also include other sites of infection, including strategies for pulmonary crypto-coccosis. Emphasis has been placed on potential complications in management of cryptococcal infection, including increased intracranial pressure, immune reconstitution inflammatory syndrome (IRIS), drug resistance, and crypto-coccomas. Three key management principles have been articulated: (1) induction therapy for meningoencephalitis using fungicidal regimens, such as a polyene and flucytosine, followed by suppressive regimens using fluconazole; (2) importance of early recognition and treatment of increased intracranial pressure and/or IRIS; and (3) the use of lipid formulations of amphotericin B regimens in patients with renal impairment. Cryptococcosis remains a challenging management issue, with little new drug development or recent definitive studies. However, if the diagnosis is made early, if clinicians adhere to the basic principles of these guidelines, and if the underlying disease is controlled, then cryptococcosis can be managed successfully in the vast majority of patients.
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影响因子：
39.2
作者：
APPELBAUM, E;SHTOKALKO, S
通讯作者：
SHTOKALKO, S
影响因子：
3.7
作者：
Charlier C;Dromer F;Lévêque C;Chartier L;Cordoliani YS;Fontanet A;Launay O;Lortholary O;French Cryptococcosis Study Group
通讯作者：
French Cryptococcosis Study Group
DOI：
10.1007/s10096-008-0529-z
发表时间：
2008-10-01
影响因子：
4.5
作者：
Baddley, J. W.;Perfect, J. R.;Pappas, P. G.
通讯作者：
Pappas, P. G.
影响因子：
168.9
作者：
Brouwer, AE;Rajanuwong, A;Harrison, TS
通讯作者：
Harrison, TS
影响因子：
4.9
作者：
Aller, AI;Martin-Mazuelos, E;Espinel-Ingroff, A
通讯作者：
Espinel-Ingroff, A