Publication details
Diagnostika a léčba kryptokokové meningitidy
| Title in English | Diagnosis and Treatment of Cryptococcal Meningitis |
|---|---|
| Authors | |
| Year of publication | 2026 |
| Type | Peer-reviewed scientific article |
| Magazine / Source | KLINICKÁ MIKROBIOLOGIE A INFEKČNÍ LÉKAŘSTVÍ |
| MU Faculty or unit | |
| Citation | |
| web | https://trios.cz/odborne-casopisy/kmil/ |
| Keywords | cryptococcal meningitis; Cryptococcus neoformans; sarcoidosis; opportunistic mycosis |
| Description | Cryptococcal meningitis represents a serious opportunistic fungal neuroinfection associated with high mortality, particularly in patients with impaired cellular immunity. Although the disease is traditionally linked to advanced HIV infection, in recent years, we have observed an increasing number of cases in non-HIV patients as well. The article summarizes current knowledge on the etiopathogenesis, clinical presentation, diagnosis, and treatment of this condition. Emphasis is placed on the importance of early diagnosis through detection of the cryptococcal antigen and molecular genetic methods, which significantly accelerate establishment of the diagnosis. Treatment requires a comprehensive multidisciplinary approach encompassing induction, consolidation, and maintenance antifungal therapy, with the combination of liposomal amphotericin B and flucytosine followed by triazole antifungals remaining the standard of care. The article also includes a case report of a young HIV-negative patient with meningitis caused by Cryptococcus neoformans. While searching for secondary immunodeficiency, the patient was diagnosed with sarcoidosis – a condition itself representing a strong predisposing factor associated with impaired cellular immunity. Thus, the case report underscores the necessity of considering cryptococcosis even in seemingly immunocompetent individuals and of always searching for an underlying immunodeficiency. |