Messina, F.; Santiso, G.; Arechavala, A.; Romero, M.; Depardo, R.; Marin, E. Preemptive Therapy in Cryptococcosis Adjusted for Outcomes. J. Fungi2023, 9, 631.
Messina, F.; Santiso, G.; Arechavala, A.; Romero, M.; Depardo, R.; Marin, E. Preemptive Therapy in Cryptococcosis Adjusted for Outcomes. J. Fungi 2023, 9, 631.
Messina, F.; Santiso, G.; Arechavala, A.; Romero, M.; Depardo, R.; Marin, E. Preemptive Therapy in Cryptococcosis Adjusted for Outcomes. J. Fungi2023, 9, 631.
Messina, F.; Santiso, G.; Arechavala, A.; Romero, M.; Depardo, R.; Marin, E. Preemptive Therapy in Cryptococcosis Adjusted for Outcomes. J. Fungi 2023, 9, 631.
Abstract
Cryptococcosis is one of the most serious opportunistic diseases in patients living with HIV. For this reason, it is important to have early diagnosis and appropriate treatment.
Objectives. The aim of the study was to know the evolution of patients diagnosed with cryptococcosis by detection of Cryptococcus antigen in serum by lateral flow (CrAg LFA) without nervous system involvement and with treatment in accordance with the results.
Materials and Methods. A retrospective, longitudinal, analytical study was performed. Seventy patients with cryptococcosis initially diagnosed by serum CrAg LFA without meningeal involvement between January 2019 and April 2022 were analyzed for medical records. The treatment regimen was adapted to the results of blood culture, respiratory material or pulmonary tomography imaging.
Results. Seventy patients were included, 13 had probable pulmonary cryptococcosis, 4 had proven pulmonary cryptococcosis, 3 had fungemia and 50 had pre-emptive therapy without microbiological or imaging findings compatible with cryptococcosis. Among the 50 patients with pre-emptive therapy, none had meningeal involvement or cryptococcosis recurrences to date.
Conclusion. Pre-emptive therapy avoided progression to meningitis in patients with CrAg LFA-positive patients. Pre-emptive therapy with dose adjustment of fluconazole in patients with the mentioned characteristics was useful despite the use of lower doses than recommended.
Medicine and Pharmacology, Epidemiology and Infectious Diseases
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