Cryptococcosis primary prevention: Difference between revisions
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*Take the lowest doses of [[corticosteroid]] medications possible. | *Take the lowest doses of [[corticosteroid]] medications possible. | ||
*Practice [[safe sex]] to reduce the risk of getting [[HIV]] and other [[infections]] associated with a [[Weakened immune systems|weakened immune system]]. | *Practice [[safe sex]] to reduce the risk of getting [[HIV]] and other [[infections]] associated with a [[Weakened immune systems|weakened immune system]]. | ||
*[[Cryptococcal Meningitis|Cryptococcal meningitis]] commonly affects patients with a [[CD4]] count of ≤ 100 cells/μl. It is | *[[Cryptococcal Meningitis|Cryptococcal meningitis]] commonly affects patients with a [[CD4]] count of ≤ 100 cells/μl. It is a major cause of [[mortality]] and [[morbidity]] in [[Human Immunodeficiency Virus (HIV)|HIV]] positive individuals. It is recommended that patients with [[CD4]] counts ≤ 100 cells/μl should have routine [[Cryptococcosis|cryptococcal]] [[antigen]] screenings. Patients with a positive result should be offered preemptive [[Antifungal drug|anti-fungal therapy]].<ref name="pmid28166254">{{cite journal| author=Cassim N, Schnippel K, Coetzee LM, Glencross DK| title=Establishing a cost-per-result of laboratory-based, reflex Cryptococcal antigenaemia screening (CrAg) in HIV+ patients with CD4 counts less than 100 cells/μl using a Lateral Flow Assay (LFA) at a typical busy CD4 laboratory in South Africa. | journal=PLoS One | year= 2017 | volume= 12 | issue= 2 | pages= e0171675 | pmid=28166254 | doi=10.1371/journal.pone.0171675 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28166254 }} </ref><ref name="pmid28134711">{{cite journal| author=Greene G, Sriruttan C, Le T, Chiller T, Govender NP| title=Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease. | journal=Curr Opin HIV AIDS | year= 2017 | volume= 12 | issue= 2 | pages= 139-147 | pmid=28134711 | doi=10.1097/COH.0000000000000347 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28134711 }} </ref> | ||
*One strategy to prevent [[Cryptococcal Meningitis|cryptococcal meningitis]] deaths is to treat all [[HIV]]/[[HIV AIDS|AIDS]] patients with a [[CD4]] <100 with low-dose [[fluconazole]] 200 mg daily. This has shown to decrease the number of [[Cryptococcal infection|cryptococcal infections]], but has not consistently decreased rates of death from [[Cryptococcosis|cryptococcal disease]].<ref name="urlwww.cdc.gov">{{cite web |url=https://www.cdc.gov/fungal/pdf/crypto-screen-train-manual_508c.pdf |title=www.cdc.gov |format= |work= |accessdate=}}</ref> | *One strategy to prevent [[Cryptococcal Meningitis|cryptococcal meningitis]] deaths is to treat all [[HIV]]/[[HIV AIDS|AIDS]] patients with a [[CD4]] <100 with low-dose [[fluconazole]] 200 mg daily. This has shown to decrease the number of [[Cryptococcal infection|cryptococcal infections]], but has not consistently decreased rates of death from [[Cryptococcosis|cryptococcal disease]].<ref name="urlwww.cdc.gov">{{cite web |url=https://www.cdc.gov/fungal/pdf/crypto-screen-train-manual_508c.pdf |title=www.cdc.gov |format= |work= |accessdate=}}</ref> | ||
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[[Category:Fungal diseases]] | [[Category:Fungal diseases]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
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[[Category:Infectious disease]] | |||
[[Category:Pulmonology]] | |||
[[Category:Neurology]] | |||
[[Category:Dermatology]] | |||
Latest revision as of 21:10, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
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Overview
It is recommended that patients with CD4 counts ≤ 100 cells/μl should have routine cryptococcal antigen screenings and patients with a positive result should be offered preemptive anti-fungal therapy.
Primary Prevention
- Take the lowest doses of corticosteroid medications possible.
- Practice safe sex to reduce the risk of getting HIV and other infections associated with a weakened immune system.
- Cryptococcal meningitis commonly affects patients with a CD4 count of ≤ 100 cells/μl. It is a major cause of mortality and morbidity in HIV positive individuals. It is recommended that patients with CD4 counts ≤ 100 cells/μl should have routine cryptococcal antigen screenings. Patients with a positive result should be offered preemptive anti-fungal therapy.[1][2]
- One strategy to prevent cryptococcal meningitis deaths is to treat all HIV/AIDS patients with a CD4 <100 with low-dose fluconazole 200 mg daily. This has shown to decrease the number of cryptococcal infections, but has not consistently decreased rates of death from cryptococcal disease.[3]
References
- ↑ Cassim N, Schnippel K, Coetzee LM, Glencross DK (2017). "Establishing a cost-per-result of laboratory-based, reflex Cryptococcal antigenaemia screening (CrAg) in HIV+ patients with CD4 counts less than 100 cells/μl using a Lateral Flow Assay (LFA) at a typical busy CD4 laboratory in South Africa". PLoS One. 12 (2): e0171675. doi:10.1371/journal.pone.0171675. PMID 28166254.
- ↑ Greene G, Sriruttan C, Le T, Chiller T, Govender NP (2017). "Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease". Curr Opin HIV AIDS. 12 (2): 139–147. doi:10.1097/COH.0000000000000347. PMID 28134711.
- ↑ "www.cdc.gov" (PDF).