Abstract：
Cryptococcal meningitis is an important global health problem, resulting from infection with the yeast Cryptococcus, especially Cryptococcus neoformans and Cryptococcus gattii, which cause a spectrum of disease ranging from pulmonary and skin lesions to life-threatening central nervous system involvement. The diagnosis and management of cryptococcal meningitis have substantially changed in recent years. Cryptococcal meningitis often occurs in people living with advanced HIV infection, though in high-income countries with robust HIV detection and treatment programmes, it increasingly occurs in other groups, notably solid-organ transplant recipients, other immunosuppressed patients and even immunocompetent hosts. This review outlines the clinical presentation, management and prognosis of cryptococcal meningitis, including its salient differences in people living with HIV compared with HIV-negative patients. We discuss the importance of managing raised intracranial pressure and highlight the advantages of improved multidisciplinary team working involving neurologists, infectious disease specialists and neurosurgeons.
摘要：
隐球菌性脑膜炎是一个重要的全球健康问题，由于酵母隐球菌感染，尤其是新生隐球菌和加蒂隐球菌，导致一系列疾病，从肺部和皮肤损伤到危及生命的中枢神经系统受累。近年来，隐球菌性脑膜炎的诊断和治疗发生了很大变化。隐球菌性脑膜炎通常发生在患有晚期HIV感染的人中，尽管在高收入国家拥有强大的艾滋病毒检测和治疗计划，它越来越多地发生在其他群体中，特别是实体器官移植接受者，其他免疫抑制患者，甚至免疫能力强的宿主。这篇综述概述了临床表现，隐球菌性脑膜炎的治疗和预后，包括与HIV阴性患者相比，HIV感染者的显着差异。我们讨论了管理颅内压升高的重要性，并强调了改善多学科团队工作的优势，包括神经科医师。传染病专家和神经外科医生。
