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

Christina Chang (1) , Thomas Harrison , Tihana Bicanic , Methee Chayakulkeeree , Tania Sorrell , Adilia Warris , Ferry Hagen , Andrej Spec , Rita Oladele , Nelesh Govender , Sharon Chen , Christopher Mody , Andreas Groll , Yee-Chun Chen , Michail Lionakis , Alexandre Alanio (2, 3, 4) , Elizabeth Castañeda , Jairo Lizarazo , José Vidal , Takahiro Takazono , Martin Hoenigl , Jan-Willem Alffenaar , Jean-Pierre Gangneux (5, 6) , Rajeev Soman , Li-Ping Zhu , Alexandro Bonifaz , Joseph Jarvis , Jeremy Day , Nikolai Klimko , Jon Salmanton-García , Grégory Jouvion (7) , David Meya , David Lawrence , Sebastian Rahn , Felix Bongomin , Brendan Mcmullan , Rosanne Sprute , Tinashe Nyazika , Justin Beardsley , Fabianne Carlesse , Christopher Heath , Olusola Ayanlowo , Olga Mashedi , Flavio Queiroz-Telles Filho , Mina Hosseinipour , Atul Patel , Elvis Temfack , Nina Singh , Oliver Cornely , David Boulware , Olivier Lortholary (8, 9, 10, 2) , Peter Pappas , John Perfect (11)

1 Monash University [Melbourne]
2 CNRMA - Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals
3 Mycologie translationnelle - Translational Mycology
4 AP-HP - Hopital Saint-Louis [AP-HP]
5 Irset - Institut de recherche en santé, environnement et travail
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 DYNAMIC - Dynamic Microbiology - EA 7380
8 Centre d'infectiologie Necker-Pasteur [CHU Necker]
9 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
10 Mycologie moléculaire - Molecular Mycology
11 Duke University Medical Center

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.

Domaines: Sciences du Vivant [q-bio]

Christina Chang, Thomas Harrison, Tihana Bicanic, Methee Chayakulkeeree, Tania Sorrell, et al.. Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM. The Lancet Infectious Diseases, In press, ⟨10.1016/s1473-3099(23)00731-4⟩. ⟨hal-04456878⟩