Cryptococcosis is an infectious disease with worldwide distribution and wide array of clinical presentations caused by pathogenic encapsulated yeasts in the genus Cryptococcus. Currently, there are 2 species of Cryptococcus that commonly cause disease in humans: Cryptococcus neoformans and Cryptococcus gattii. C neoformans was first identified as a human pathogen in the late 19th century, but was not recognized as a common cause of human disease until the late 1970s. Over the last several decades, as vulnerable populations have expanded, cryptococcal meningitis became an infection of global importance, with up to 1 million new infections annually and significant attributable morbidity and mortality, especially among patients with human immunodeficiency virus (HIV) infection and AIDS. Although C neoformans and C gattii share many features of a highly evolved, environmentally savvy yeast, there are important species- and strain-specific differences with respect to geographic distribution, environmental niches, host predilection, and clinical manifestations that should be emphasized. As molecular techniques of identification have evolved, we have gained further insight into the pathobiology of these encapsulated yeasts, and their capacity to adapt to environmental pressures, exploit new geographic environments, and cause disease in both immunocompromised and apparently immunocompetent hosts. Despite increased availability of and success with antiretroviral therapy (ART), the worldwide burden of and mortality associated cryptococcal disease remains unacceptably high, and novel strategies of screening and preemptive therapy offer great promise at making a sustained and much needed impact on this sugarcoated opportunistic infection.
The medicines that can be thought of use are:
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