Cryptococcosis screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Serge Korjian M.D.; Yazan Daaboul, M.D.

Overview

Asymptomatic cryptococcal antigenemia is very common in areas with endemic HIV/AIDS, and is associated with increased mortality and incidence of cryptococcal meningitis. Screening is not recommended for HIV/AIDS patients in the United States or Europe. However, screening may be beneficial in countries with limited HAART availability, high levels of antiretroviral drug resistance, and a high burden of disease. In the absence of symptoms, positive cryptococcal antigenemia should be treated with fluconazole 400 mg orally, once daily.

Screening

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References

  1. 1.0 1.1 Kaplan JE, Vallabhaneni S, Smith RM, Chideya-Chihota S, Chehab J, Park B (2015). "Cryptococcal antigen screening and early antifungal treatment to prevent cryptococcal meningitis: a review of the literature". J Acquir Immune Defic Syndr. 68 Suppl 3: S331–9. doi:10.1097/QAI.0000000000000484. PMID 25768872.
  2. Preventing Deaths Due to Cryptococcus with Targeted Screening. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/fungal/diseases/cryptococcosis-neoformans/screening.html. Accessed on December 20, 2015
  3. Kabanda T, Siedner MJ, Klausner JD, Muzoora C, Boulware DR (2014). "Point-of-care diagnosis and prognostication of cryptococcal meningitis with the cryptococcal antigen lateral flow assay on cerebrospinal fluid". Clin Infect Dis. 58 (1): 113–6. doi:10.1093/cid/cit641. PMC 3864499. PMID 24065327.
  4. 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.
  5. 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.
  6. Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ; et al. (2010). "Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america". Clin Infect Dis. 50 (3): 291–322. doi:10.1086/649858. PMID 20047480.
  7. Desmet P, Kayembe KD, De Vroey C (1989). "The value of cryptococcal serum antigen screening among HIV-positive/AIDS patients in Kinshasa, Zaire". AIDS. 3 (2): 77–8. PMID 2496722.
  8. Tassie JM, Pepper L, Fogg C, Biraro S, Mayanja B, Andia I; et al. (2003). "Systematic screening of cryptococcal antigenemia in HIV-positive adults in Uganda". J Acquir Immune Defic Syndr. 33 (3): 411–2. PMID 12843756.
  9. 9.0 9.1 Jarvis JN, Lawn SD, Vogt M, Bangani N, Wood R, Harrison TS (2009). "Screening for cryptococcal antigenemia in patients accessing an antiretroviral treatment program in South Africa". Clin Infect Dis. 48 (7): 856–62. doi:10.1086/597262. PMC 2875173. PMID 19222372.

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