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Cryptococcus neoformans: Treatment of meningoencephalitis and disseminated infection in HIV seronegative patients

Gary M Cox, MD
John R Perfect, MD
Section Editors
Carol A Kauffman, MD
Sheldon L Kaplan, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Most patients with cryptococcal meningoencephalitis are immunocompromised. The most common forms of immunosuppression other than HIV include glucocorticoid therapy, biologic modifiers, solid organ transplantation, cancer (particularly hematologic malignancy), and conditions such as sarcoidosis and hepatic failure. For such patients, the clinical presentation is variable. Some patients have symptoms for up to several months prior to diagnosis, whereas others present with an acute illness of only a few days. Typically, headache, lethargy, personality changes, and memory loss develop over two to four weeks. Patients may also present with disseminated disease to other body sites.

Issues related to treatment of Cryptococcus neoformans in HIV-uninfected patients will be reviewed here. Other topic reviews related to cryptococcal disease include:

(See "Microbiology and epidemiology of Cryptococcus neoformans infection".)

(See "Clinical manifestations and diagnosis of Cryptococcus neoformans meningoencephalitis in HIV-seronegative patients".)

(See "Cryptococcus neoformans infection outside the central nervous system".)

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Literature review current through: Nov 2017. | This topic last updated: Mar 30, 2017.
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