ABSTRACT
Cryptococcus is a globally invasive mycosis that continues to primarily infect immunocompromised patients with significant morbidity and mortality. Cryptococcal meningitis is the most common central nervous system infection in the world today. Three major human host categories exist for this yeast infection: HIV patients, organ transplant recipients, and non-HIV and non-transplant patients. Despite rates of cryptococcal infection improving after the introduction of HAART for HIV, cryptococcal infection continues to burden the HIV population and the numbers of organ transplant recipients and patients receiving immunosuppressive therapy continue to enlarge. The mainstay of therapy remains systemic antifungal agents with the goal of rapidly and effectively reducing fungal burden. In this chapter, we discuss the different cryptococcal infections, the antifungal strategies needed for treatment success and their limitations, as well as highlight new screening diagnostic tools that may improve outcomes particularly in resource-limited settings.
