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Cryptococcal meningoencephalitis: time for action
- Source :
- The Lancet Infectious Diseases. 21:e259-e271
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Cryptococcal meningoencephalitis was first described over a century ago. This fungal infection is preventable and treatable yet continues to be associated with excessive morbidity and mortality. The largest burden of disease resides in people living with HIV in low-income and middle-income countries. In this group, mortality with the best antifungal induction regimen (7 days of amphotericin B deoxycholate [1·0 mg/kg per day] and flucytosine [100·0 mg/kg per day]) in a clinical trial setting was 24% at 10 weeks. The world is now at an inflection point in terms of recognition, research, and action to address the burden of morbidity and mortality from cryptococcal meningoencephalitis. However, the scope of interventional programmes needs to increase, with particular attention to implementation science that is specific to individual countries. This Review summarises causes of excessive mortality, interventions with proven survival benefit, and gaps in knowledge and practice that contribute to the ongoing high death toll from cryptococcal meningoencephalitis. TRANSLATIONS: For the Vietnamese and Chichewa translations of the abstract see Supplementary Materials section.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Antifungal Agents
Databases, Factual
030106 microbiology
Flucytosine
03 medical and health sciences
0302 clinical medicine
Pharmacotherapy
Meningoencephalitis
Amphotericin B
Amphotericin B deoxycholate
Humans
Medicine
030212 general & internal medicine
Intensive care medicine
Fluconazole
business.industry
Cryptococcosis
medicine.disease
Clinical trial
Drug Combinations
Regimen
Infectious Diseases
Drug Therapy, Combination
business
Deoxycholic Acid
medicine.drug
Subjects
Details
- ISSN :
- 14733099
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- The Lancet Infectious Diseases
- Accession number :
- edsair.doi.dedup.....671254f7d8e192e6676eca51747fdb56