Reframing the clinical phenotype and management of cryptococcal meningitis.

IF 2.4 Q2 CLINICAL NEUROLOGY
Maria Francisca Rocha, Hamish D C Bain, Neil Stone, David Meya, Lucia Darie, Ahmed K Toma, Michael P T Lunn, Arpan R Mehta, Charles Coughlan
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引用次数: 0

Abstract

Cryptococcal meningitis is an important global health problem, resulting from infection with the yeast Cryptococcus, especially Cryptococcus neoformans and Cryptococcus gattii, which cause a spectrum of disease ranging from pulmonary and skin lesions to life-threatening central nervous system involvement. The diagnosis and management of cryptococcal meningitis have substantially changed in recent years. Cryptococcal meningitis often occurs in people living with advanced HIV infection, though in high-income countries with robust HIV detection and treatment programmes, it increasingly occurs in other groups, notably solid-organ transplant recipients, other immunosuppressed patients and even immunocompetent hosts. This review outlines the clinical presentation, management and prognosis of cryptococcal meningitis, including its salient differences in people living with HIV compared with HIV-negative patients. We discuss the importance of managing raised intracranial pressure and highlight the advantages of improved multidisciplinary team working involving neurologists, infectious disease specialists and neurosurgeons.

重塑隐球菌脑膜炎的临床表型和管理。
隐球菌脑膜炎是一个重要的全球性健康问题,由隐球菌酵母菌感染引起,尤其是新变形隐球菌和加特隐球菌,可引起从肺部和皮肤病变到危及生命的中枢神经系统受累等一系列疾病。近年来,隐球菌性脑膜炎的诊断和治疗方法发生了很大变化。隐球菌性脑膜炎通常发生在晚期艾滋病病毒感染者中,但在艾滋病病毒检测和治疗计划健全的高收入国家,隐球菌性脑膜炎越来越多地发生在其他群体中,尤其是实体器官移植受者、其他免疫抑制患者甚至免疫功能健全的宿主。本综述概述了隐球菌脑膜炎的临床表现、管理和预后,包括艾滋病病毒感染者与艾滋病病毒阴性患者的显著差异。我们讨论了处理颅内压升高的重要性,并强调了神经科医生、传染病专家和神经外科医生共同参与的多学科团队工作的优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
PRACTICAL NEUROLOGY
PRACTICAL NEUROLOGY Medicine-Neurology (clinical)
CiteScore
3.70
自引率
3.60%
发文量
113
期刊介绍: The essential point of Practical Neurology is that it is practical in the sense of being useful for everyone who sees neurological patients and who wants to keep up to date, and safe, in managing them. In other words this is a journal for jobbing neurologists - which most of us are for at least part of our time - who plough through the tension headaches and funny turns week in and week out. Primary research literature potentially relevant to routine clinical practice is far too much for any neurologist to read, let alone understand, critically appraise and assimilate. Therefore, if research is to influence clinical practice appropriately and quickly it has to be digested and provided to neurologists in an informative and convenient way.
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