Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM
Abstract
Summary Cryptococcosis, particularly in its most lethal manifestation of cryptococcal meningitis (CM), accounts for significant mortality and morbidity. It is a major worldwide disseminated invasive fungal infection. The breadth of the clinical cryptococcosis syndromes, the different host types at-risk and affected, and the vastly disparate resource settings in which clinicians practice, pose a complex array of challenges. Expert contributors from diverse regions of the world: collated data, reviewed the evidence, and provided insightful guideline recommendations for health practitioners across the globe. This guideline offers practical guidance and implementable recommendations on clinical approaches, screening, diagnosis, management, and follow-up care, and serves as a comprehensive synthesis and update on cryptococcosis. It seeks to facilitate optimal clinical decision-making on this complex condition and addresses its myriad of clinical complications, by incorporating data from historical and contemporary clinical trials, grounded on a set of core management principles, while simultaneously acknowledging the practical challenges of antifungal access and resource limitations faced by many. Over 70 societies internationally have endorsed this global cryptococcosis guideline for its content, structure, evidence, recommendation, and pragmatic wisdom to inform clinicians about the past, present, and future and in the care of a patient with cryptococcosis.
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