Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM

Christina C. Chang, Thomas S. Harrison, Tihana A. Bicanic, Methee Chayakulkeeree, Tania C. Sorrell, Adilia Warris, Ferry Hagen, Andrej Spec, Rita Oladele, Nelesh P. Govender, Sharon C. Chen, Christopher H. Mody, Andreas H. Groll, Yee Chun Chen, Michail S. Lionakis, Alexandre Alanio, Elizabeth Castañeda, Jairo Lizarazo, José E. Vidal, Takahiro TakazonoMartin Hoenigl, Jan Willem Alffenaar, Jean Pierre Gangneux, Rajeev Soman, Li Ping Zhu, Alexandro Bonifaz, Joseph N. Jarvis, Jeremy N. Day, Nikolai Klimko, Jon Salmanton-García, Grégory Jouvion, David B. Meya, David Lawrence, Sebastian Rahn, Felix Bongomin, Brendan J. McMullan, Rosanne Sprute, Tinashe K. Nyazika, Justin Beardsley, Fabianne Carlesse, Christopher H. Heath, Olusola O. Ayanlowo, Olga M. Mashedi, Flavio Queiroz-Telles Filho, Mina C. Hosseinipour, Atul K. Patel, Elvis Temfack, Nina Singh, Oliver A. Cornely, David R. Boulware, Olivier Lortholary, Peter G. Pappas, John R. Perfect

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

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

Original languageEnglish
JournalThe Lancet Infectious Diseases
DOIs
StateAccepted/In press - 2024

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