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Clinical treatment of cryptococcal meningitis: an evidence-based review on the emerging clinical data

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Abstract

Cryptococcal meningitis (CM) is a fatal fungal central nervous system (CNS) infection caused by Cryptococcus infecting the meninges and/or brain parenchyma, with fever, headache, neck stiffness, and visual disturbances as the primary clinical manifestations. Immunocompromised individuals with human immunodeficiency virus (HIV) infection or who have undergone organ transplantation, as well as immunocompetent people can both be susceptible to CM. Without treatment, patients with CM may have a mortality rate of up to 100% after hospital admission. Even after receiving therapy, CM patients may still suffer from problems such as difficulty to cure, poor prognosis, and high mortality. Therefore, timely and effective treatment is essential to improve the mortality and prognosis of CM patients. Currently, the clinical outcomes of CM are frequently unsatisfactory due to limited drug choices, severe adverse reactions, drug resistance, etc. Here, we review the research progress of CM treatment strategies and discuss the suitable options for managing CM, hoping to provide a reference for physicians to select the most appropriate treatment regimens for CM patients.

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  1. Mao-Zhu Liu, Xin-Hua Dai and Ming-Tang Zeng contributed equally to this work.

Authors and Affiliations

  1. Center of Infectious Diseases, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu, 610041, China

    Mao-Zhu Liu & En-Qiang Chen

  2. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, 610041, China

    Mao-Zhu Liu & Ming-Tang Zeng

  3. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China

    Xin-Hua Dai

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EQC contributed to the conception, manuscript review and revision, and submission, MZL was involved in literature search, original draft writing, drawing diagrams, and manuscript revision, XHD was involved in the literature search, drawing diagrams, and manuscript revision, and MTZ was involved in the literature search.

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Liu, MZ., Dai, XH., Zeng, MT. et al. Clinical treatment of cryptococcal meningitis: an evidence-based review on the emerging clinical data. J Neurol (2024). https://doi.org/10.1007/s00415-024-12193-8

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