Achtung: Bitte beachten Sie unbedingt die Nutzungsbedingungen. Trotz sorgfältiger Prüfung wird keinerlei Haftung für die dargestellten Inhalte übernommen. Alle Inhalte richten sich ausschließlich an ein ärztliches Fachpublikum.

Keine Kategorien vergeben

Opportunistische Infektionen

(Weitergeleitet von Kategorie:Opportunistische Infektionen)
Kapitelinformationen
Stand: Juni 2021
Kapitelleitung: Oliver Cornely
Autor:innen: Ronja Brockhoff, Nicola Giesen, Philipp Köhler, Jochen Schneider, Viktoria Schneitler, Rosanne Sprute, Timo Wolf,
Reviewer:innen: Christoph Spinner, Christoph Lübbert
Beteiligte Fachgesellschaften: dgi-logo.png
Feedback: Mitwirken

Immunsupprimierte Patientinnen und Patienten sind besonderes vulnerable gegenüber allen Arten von Infektionen. Erreger, die den Immungesunden selten erkranken lassen, aber bei Abwehrschwäche die Gelegenheit zu nutzen scheinen, bilden die Gruppe der opportunistischen Infektionen. Diese Pathogene sind keine taxonomisch definierte Gruppe und es ergeben sich Berührungspunkte und teils Überlappungen mit Infektionen des immungesunden Menschen.

Wir haben im Kapitel der Opportunistischen Infektionen häufige und therapierbare Erkrankungen adressiert. Die Erreger umfassen Herpesviren (HSV1, HSV2, CMV, VZV), Pilze (Aspergillus, Candida, Cryptococcus, Mucorales, Pneumocystis) und Protozoen (Toxoplasma).

Das Kapitel umfasst das gesamte Management dieser opportunistischen Erkrankungen, von der Prophylaxe über die Diagnostik bis hin zur Therapie. Für die häufigeren klinischen Situationen sollten in jedem Behandlungszentrum lokale Managementpfade als Strategie bestehen. Die Optionen, die für einzelne konkrete Patientinnen und Patienten bestehen, sind im Kapitel dargestellt und müssen individuell ausgewählt und ggf. adaptiert werden.









Unterkapitel

Unterkapitel bearbeiten

CMV
HSV
Invasive Aspergillose
Invasive Mukormykose
Kryptokokkose
VZV
Zerebrale Toxoplasmose


Quellen

  • https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Zytomegalievirus.html;jsessionid=13FA88DA454E7CD74309C4050B66B0D2.internet082#doc4738494bodyText10
  • https://www.uniklinikum-saarland.de/fileadmin/UKS/Einrichtungen/Kliniken_und_Institute/Infektionsmedizin/Prof_Transplantation/Diagnostik/2019_Schmidt_Sester_CME_CMV.pdf
  • https://www.dgho.de/publikationen/stellungnahmen/fruehe-nutzenbewertung/copy_of_letermovir/letermovir-dgho-dag-kbt-stellungnahme-20180605.pdf
  • Brodt, Hans Reinhardt: Stille Antibiotika Therapie, Klinik und Praxis der antiinfektiösen Behandlung. 2 Auflage.
  • Hoffmann C. & Rockstroh, J.: HIV 2020/ 2021. www.hivbuch.de
  • Dante P Melendez and Raymund R Razonable: Letermovir and inhibitors of the terminase complex: a promising new class of investigational antiviral drugs against human cytomegalovirus; Infect Drug Resist. 2015; 8: 269–277. Published online 2015 Aug 5. doi: 10.2147/IDR.S79131 PMCID: PMC4531042
  • https://next.amboss.com/de/article/nf0752#Z33d59c26da10cb6030670c9557deb5e5
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6431500/
  • Munro M, Yadavalli T, Fonteh C, Arfeen S, Lobo-Chan AM: Cytomegalovirus Retinitis in HIV and Non-HIV Individuals. Microorganisms. 2019 Dec 28;8(1):55. doi: 10.3390/microorganisms8010055.
  • https://www.awmf.org/uploads/tx_szleitlinien/093-002l_S2k_Virusinfektionen-Organtransplantierte-alloge-Stammzell-Transplantierten-Diagnostik-Praevention-Therapie__2019-06.pdf
  • https://www.aerzteblatt.de/nachrichten/126064/CMV-Hyperimmunglobulin-kann-Fetopathie-in-der-Schwangerschaft-nicht-verhindern
  • https://www.nejm.org/doi/full/10.1056/NEJMoa1913569
  • Gross, G. Herpes-simplex-Virusinfektionen. Hautarzt 55, 818–830 (2004). https://doi.org/10.1007/s00105-004-0785-5
    Aubert M, Strongin DE, Roychoudhury P, et al. Gene editing and elimination of latent herpes simplex virus in vivo. Nat Commun. 2020;11(1):4148. doi:10.1038/s41467-020-17936-5
  • Spengler U. Infektion der Leber mit humanen Herpesviren. :4.
  • Spengler - Infektion der Leber mit humanen Herpesviren.pdf. Accessed November 7, 2021. https://www.hepatitisandmore.de/archiv/2017-1/Hep_m1_17_FoBi_Spengler.pdf
  • Characterization of a live-attenuated HCMV-based vaccine platform | Scientific Reports. Accessed November 7, 2021. https://www.nature.com/articles/s41598-019-55508-w
  • Herpesvirus-Infektionen - Wissen @ AMBOSS. Accessed November 7, 2021. https://www.amboss.com/de/wissen/Herpesvirus-Infektionen/
  • LL 030 100 Virale Meningoenzephalitis 2018 - Deutsche Gesellschaft für Neurologie e. V. Deutsche Gesellschaft für Neurologie e. V. Accessed November 7, 2021. https://dgn.org/leitlinien/ll-030-100-virale-meningoenzephalitis-2018/
  • LL OI 2014-2.pdf. Accessed November 7, 2021. https://daignet.de/site-content/hiv-leitlinien/leitlinien-1/LL%20OI%202014-2.pdf
  • Opportunistische Infektionen | SpringerLink. Accessed November 7, 2021. https://link.springer.com/article/10.1007/s00108-019-0624-5
  • RKI - Infektionskrankheiten A-Z - Herpes-Infektionen (Herpes simplex). Accessed November 7, 2021. https://www.rki.de/DE/Content/InfAZ/H/Herpes/Herpes.html
  • https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Toxoplasmose.html;jsessionid=6F4003131E144DDB68FB03F9762455B6.internet082
  • Pleyer U, Gross U, Schlüter D, Wilking H, Seeber F. Toxoplasmosis in Germany. Dtsch Arztebl Int. 2019;116(25):435-444. doi:10.3238/arztebl.2019.0435
  • Schmidt-Hieber M, Silling G, Schalk E, et al. CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)-Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Oncol. 2016;27(7):1207-1225. doi:10.1093/annonc/mdw155
  • Ullmann AJ, Schmidt-Hieber M, Bertz H, et al. Infectious diseases in allogeneic haematopoietic stem cell transplantation: prevention and prophylaxis strategy guidelines 2016. Ann Hematol. 2016;95(9):1435-1455. doi:10.1007/s00277-016-2711-1
  • LL OI 2014-2.pdf. Accessed November 7, 2021. https://daignet.de/site-content/hiv-leitlinien/leitlinien-1/LL%20OI%202014-2.pdf
  • Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis 2011;52:e56-93.
  • Harpaz R, Ortega-Sanchez IR, Seward JF. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2008;57:1-30; quiz CE2-4.
  • RKI Ratgeber Windpocken (Varizellen), Gürtelrose (Herpes zoster). https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Varizellen.html. Aufgerufen am 08.07.2021
  • Sauerbrei A. Diagnosis, antiviral therapy, and prophylaxis of varicella-zoster virus infections. Eur J Clin Microbiol Infect Dis 2016;35:723-34.
  • Sauerbrei A, Eichhorn U, Schacke M, Wutzler P. Laboratory diagnosis of herpes zoster. J Clin Virol 1999;14:31-6.
  • Siedler A, Koch J. Herpes zoster: Wer wie geimpft werden sollte. Dtsch Arztebl 2019; 116(23-24): A-1182 / B-978 / C-96.
  • Sprute R, Koehler P, Cornely OA. Herpes Viruses. In Cornely OA, Hoenigl M (eds.), Infection Management in Hematology, Hematologic Malignancies, Springer Nature Switzerland AG 2021. Doi 10.1007/978-3-030-57317-1_13
  • Ständige Impfkommission: Empfehlungen der Ständigen Impfkommission (STIKO) beim Robert Koch-Institut 2021. Epid Bull 2021;34:3- 63, DOI 10.25646/8824. https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2021/Ausgaben/34_21.pdf?__blob=publicationFile. Aufgerufen am 21.09.2021
  • Styczynski J, Reusser P, Einsele H, et al. Management of HSV, VZV and EBV infections in patients with hematological malignancies and after SCT: guidelines from the Second European Conference on Infections in Leukemia. Bone Marrow Transplant 2009;43:757-70.
  • Ullmann AJ, Schmidt-Hieber M, Bertz H, et al. Infectious diseases in allogeneic haematopoietic stem cell transplantation: prevention and prophylaxis strategy guidelines 2016. Ann Hematol 2016;95:1435-55.
  • Wade JC. Viral infections in patients with hematological malignancies. Hematology Am Soc Hematol Educ Program 2006:368-74.
  • Wharton M. The epidemiology of varicella-zoster virus infections. Infect Dis Clin North Am 1996;10:571-81.
  • Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019;19(12):e405-e421. doi:10.1016/S1473-3099(19)30312-3
  • Imhof A, Balajee SA, Fredricks DN, Englund JA, Marr KA. Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole. Clin Infect Dis 2004; 39(5): 743-6. Referenzfehler
  • Marty FM, Cosimi LA, Baden LR. Breakthrough zygomycosis after voriconazole treatment in recipients of hematopoietic stem-cell transplants. N Engl J Med2004; 350(9): 950-2. Maschmeyer G, Patterson TF. Our 2014 approach to breakthrough invasive fungal infections. Mycoses 2014; 57(11): 645-51.
  • Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347(6): 408-15.
  • Cornely OA, Koehler P, Arenz D, S CM. EQUAL Aspergillosis Score 2018: An ECMM score derived from current guidelines to measure QUALity of the clinical management of invasive pulmonary aspergillosis. Mycoses 2018; 61(11): 833-6.
  • Marr KA, Schlamm HT, Herbrecht R, et al. Combination antifungal therapy for invasive aspergillosis: a randomized trial. Annals of internal medicine 2015; 162(2): 81-9.
  • Patterson TF, Thompson GR, 3rd, Denning DW, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 2016; 63(4): e1-e60.
  • Mousset S, Buchheidt D, Heinz W, et al. Treatment of invasive fungal infections in cancer patients-updated recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Annals of hematology 2014; 93(1): 13-32.
  • Koehler P, Cornely OA. Contemporary Strategies in the Prevention and Management of Fungal Infections. Infectious disease clinics of North America 2016; 30(1): 265-75.
  • Verweij PE, Ananda-Rajah M, Andes D, et al. International expert opinion on the management of infection caused by azole-resistant Aspergillus fumigatus. Drug resistance updates : reviews and commentaries in antimicrobial and anticancer chemotherapy 2015; 21-22: 30-40
  • Howard A, Hoffman J, Sheth A. Clinical application of voriconazole concentrations in the treatment of invasive aspergillosis. Ann Pharmacother 2008; 42(12): 1859-64.
  • Steinbach WJ, Benjamin DK, Jr., Kontoyiannis DP, et al. Infections due to Aspergillus terreus: a multicenter retrospective analysis of 83 cases. Clin Infect Dis 2004; 39(2): 192-8.
  • Balajee SA, Nickle D, Varga J, Marr KA. Molecular studies reveal frequent misidentification of Aspergillus fumigatus by morphotyping. Eukaryotic cell 2006; 5(10): 1705-12.
  • Vinh DC, Shea YR, Sugui JA, et al. Invasive aspergillosis due to Neosartorya udagawae. Clin Infect Dis 2009; 49(1): 102-11.
  • Hamprecht A, Buchheidt D, Vehreschild JJ, et al. Azole-resistant invasive aspergillosis in a patient with acute myeloid leukaemia in Germany. Euro Surveill 2012; 17(36): 20262.
  • Steinmann J, Hamprecht A, Vehreschild MJ, et al. Emergence of azole-resistant invasive aspergillosis in HSCT recipients in Germany. J Antimicrob Chemother2015; 70(5): 1522-6.
  • van Paassen J, Russcher A, In 't Veld-van Wingerden AW, Verweij PE, Kuijper EJ. Emerging aspergillosis by azole-resistant Aspergillus fumigatus at an intensive care unit in the Netherlands, 2010 to 2013. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 2016; 21(30).
  • Snelders E, van der Lee HA, Kuijpers J, et al. Emergence of azole resistance in Aspergillus fumigatus and spread of a single resistance mechanism. PLoS medicine2008; 5(11): e219.
  • van der Linden JW, Camps SM, Kampinga GA, et al. Aspergillosis due to voriconazole highly resistant Aspergillus fumigatus and recovery of genetically related resistant isolates from domiciles. Clin Infect Dis 2013; 57(4): 513-20.
  • Koehler P, Hamprecht A, Bader O, et al. Epidemiology of invasive aspergillosis and azole resistance in patients with acute leukaemia: the SEPIA Study. International journal of antimicrobial agents 2017; 49(2): 218-23.
  • Patterson TF, Thompson GR, 3rd, Denning DW, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 2016; 63(4): e1-e60.
  • Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis 2011; 52(4): e56-93.
  • Maertens J, Marchetti O, Herbrecht R, et al. European guidelines for antifungal management in leukemia and hematopoietic stem cell transplant recipients: summary of the ECIL 3--2009 update. Bone marrow transplantation 2011; 46(5): 709-18.
  • Tacke D, Buchheidt D, Karthaus M, et al. Primary prophylaxis of invasive fungal infections in patients with haematologic malignancies. 2014 update of the recommendations of the Infectious Diseases Working Party of the German Society for Haematology and Oncology. Annals of hematology 2014; 93(9): 1449-56.
  • Tomblyn M, Chiller T, Einsele H, et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant 2009; 15(10): 1143-238.
  • Cornely OA, Maertens J, Winston DJ, et al. Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med 2007; 356(4): 348-59
  • Ullmann AJ, Lipton JH, Vesole DH, et al. Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N Engl J Med 2007; 356(4): 335-47.
  • Sivak-Callcott JA, Livesley N, Nugent RA, Rasmussen SL, Saeed P, Rootman J. Localised invasive sino-orbital aspergillosis: characteristic features. The British journal of ophthalmology 2004; 88(5): 681-7.
  • Fernandez-Ruiz M, Silva JT, San-Juan R, et al. Aspergillus tracheobronchitis: report of 8 cases and review of the literature. Medicine 2012; 91(5): 261-73.
  • Machida U, Kami M, Kanda Y, et al. Aspergillus tracheobronchitis after allogeneic bone marrow transplantation. Bone marrow transplantation 1999; 24(10): 1145-9.
  • van Assen S, Bootsma GP, Verweij PE, Donnelly JP, Raemakers JM. Aspergillus tracheobronchitis after allogeneic bone marrow transplantation. Bone marrow transplantation 2000; 26(10): 1131-2.
  • Segal BH. Aspergillosis. N Engl J Med 2009; 360(18): 1870-84.
  • Lambourne J, Agranoff D, Herbrecht R, et al. Association of mannose-binding lectin deficiency with acute invasive aspergillosis in immunocompromised patients. Clin Infect Dis 2009; 49(10): 1486-91.
  • Cunha C, Aversa F, Lacerda JF, et al. Genetic PTX3 deficiency and aspergillosis in stem-cell transplantation. The New England journal of medicine 2014; 370(5): 421-32.
  • Bochud PY, Chien JW, Marr KA, et al. Toll-like receptor 4 polymorphisms and aspergillosis in stem-cell transplantation. N Engl J Med 2008; 359(17): 1766-77.
  • Cunha C, Di Ianni M, Bozza S, et al. Dectin-1 Y238X polymorphism associates with susceptibility to invasive aspergillosis in hematopoietic transplantation through impairment of both recipient- and donor-dependent mechanisms of antifungal immunity. Blood 2010; 116(24): 5394-402.
  • Marr KA, Carter RA, Crippa F, Wald A, Corey L. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 2002; 34(7): 909-17.
  • Schauwvlieghe A, Rijnders BJA, Philips N, et al. Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study. The Lancet Respiratory medicine 2018; 6(10): 782-92.
  • Koehler P, Cornely OA, Bottiger BW, et al. COVID-19 associated pulmonary aspergillosis. Mycoses 2020; 63(6): 528-34.
  • Koehler P, Hamprecht A, Bader O, et al. Epidemiology of invasive aspergillosis and azole resistance in patients with acute leukaemia: the SEPIA Study. International journal of antimicrobial agents 2017; 49(2): 218-23.
  • Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347(6): 408-15.
  • Nivoix Y, Velten M, Letscher-Bru V, et al. Factors associated with overall and attributable mortality in invasive aspergillosis. Clin Infect Dis 2008; 47(9): 1176-84.
  • Parody R, Martino R, Sanchez F, Subira M, Hidalgo A, Sierra J. Predicting survival in adults with invasive aspergillosis during therapy for hematological malignancies or after hematopoietic stem cell transplantation: Single-center analysis and validation of the Seattle, French, and Strasbourg prognostic indexes. American journal of hematology 2009; 84(9): 571-8.
  • Upton A, Kirby KA, Carpenter P, Boeckh M, Marr KA. Invasive aspergillosis following hematopoietic cell transplantation: outcomes and prognostic factors associated with mortality. Clin Infect Dis 2007; 44(4): 531-40.
  • Georgiadou SP, Sipsas NV, Marom EM, Kontoyiannis DP. The diagnostic value of halo and reversed halo signs for invasive mold infections in compromised hosts. Clin Infect Dis2011; 52(9): 1144-55.
  • Caillot D, Casasnovas O, Bernard A, et al. Improved management of invasive pulmonary aspergillosis in neutropenic patients using early thoracic computed tomographic scan and surgery. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 1997; 15(1): 139-47.
  • Stanzani M, Battista G, Sassi C, et al. Computed tomographic pulmonary angiography for diagnosis of invasive mold diseases in patients with hematological malignancies. Clin Infect Dis 2012; 54(5): 610-6.
  • Stanzani M, Sassi C, Lewis RE, et al. High resolution computed tomography angiography improves the radiographic diagnosis of invasive mold disease in patients with hematological malignancies. Clin Infect Dis 2015; 60(11): 1603-10.
  • Sampsonas F, Kontoyiannis DP, Dickey BF, Evans SE. Performance of a standardized bronchoalveolar lavage protocol in a comprehensive cancer center: a prospective 2-year study. Cancer 2011; 117(15): 3424-33.
  • Shannon VR, Andersson BS, Lei X, Champlin RE, Kontoyiannis DP. Utility of early versus late fiberoptic bronchoscopy in the evaluation of new pulmonary infiltrates following hematopoietic stem cell transplantation. Bone marrow transplantation 2010; 45(4): 647-55.
  • Maertens J, Theunissen K, Verbeken E, et al. Prospective clinical evaluation of lower cut-offs for galactomannan detection in adult neutropenic cancer patients and haematological stem cell transplant recipients. British journal of haematology2004; 126(6): 852-60.
  • Marr KA, Balajee SA, McLaughlin L, Tabouret M, Bentsen C, Walsh TJ. Detection of galactomannan antigenemia by enzyme immunoassay for the diagnosis of invasive aspergillosis: variables that affect performance. J Infect Dis 2004; 190(3): 641-9.
  • Miceli MH, Maertens J. Role of Non-Culture-Based Tests, with an Emphasis on Galactomannan Testing for the Diagnosis of Invasive Aspergillosis. Semin Respir Crit Care Med2015; 36(5): 650-61.
  • Pfeiffer CD, Fine JP, Safdar N. Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. Clin Infect Dis 2006; 42(10): 1417-727.
  • Cornely OA, Koehler P, Arenz D, S CM. EQUAL Aspergillosis Score 2018: An ECMM score derived from current guidelines to measure QUALity of the clinical management of invasive pulmonary aspergillosis. Mycoses 2018; 61(11): 833-6.
  • Pappas PG. Cryptococcal infections in non-HIV-infected patients. Trans Am Clin Climatol Assoc. 2013;124:61-79.
  • Negroni R. Cryptococcosis. Clin Dermatol. 2012;30(6):599-609.
  • Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. . Available at http://aidsinfonihgov/contentfiles/lvguidelines/adult_oipdf  Accessed on 02 02 2020W1-W18
  • Kluger N, Poirier P, Guilpain P, Baixench MT, Cohen P, Paugam A. Cryptococcal meningitis in a patient treated with infliximab and mycophenolate mofetil for Behcet's disease. Int J Infect Dis. 2009;13(5):e325.
  • Iwata T, Nagano T, Tomita M, et al. Adalimumab-associated pulmonary cryptococcosis. Ann Thorac Cardiovasc Surg. 2011;17(4):390-393.
  • Ingram PR, Howman R, Leahy MF, Dyer JR. Cryptococcal immune reconstitution inflammatory syndrome following alemtuzumab therapy. Clin Infect Dis. 2007;44(12):e115-117.
  • Messina JA, Maziarz EK, Spec A, Kontoyiannis DP, Perfect JR. Disseminated Cryptococcosis With Brain Involvement in Patients With Chronic Lymphoid Malignancies on Ibrutinib. Open Forum Infect Dis. 2017;4(1):ofw261.
  • Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. AIDS. 2009;23(4):525-530.
  • Chen J, Zhang R, Shen Y, et al. Serum cryptococcal antigen titre as a diagnostic tool and a predictor of mortality in HIV-infected patients with cryptococcal meningitis. HIV Med. 2019;20(1):69-73.
  • Pongmekin P, Chongtrakool P, Santanirand P, Kiertiburanakul S. Clinical characteristics and mortality risk factors of cryptococcal infection among HIV-negative patients. J Med Assoc Thai. 2014;97(1):36-43.
  • Jean SS, Fang CT, Shau WY, et al. Cryptococcaemia: clinical features and prognostic factors. QJM. 2002;95(8):511-518.
  • Sajadi MM, Roddy KM, Chan-Tack KM, Forrest GN. Risk factors for mortality from primary cryptococcosis in patients with HIV. Postgrad Med. 2009;121(2):107-113.
  • Shaunak S, Schell WA, Perfect JR. Cryptococcal meningitis with normal cerebrospinal fluid. J Infect Dis. 1989;160(5):912.
  • Ford N, Shubber Z, Jarvis JN, et al. CD4 Cell Count Threshold for Cryptococcal Antigen Screening of HIV-Infected Individuals: A Systematic Review and Meta-analysis. Clin Infect Dis. 2018;66(suppl_2):S152-S159.
  • Nelson M, Dockrell D, Edwards S, et al. British HIV Association and British Infection Association guidelines for the treatment of opportunistic infection in HIV-seropositive individuals 2011. HIV Med. 2011;12 Suppl 2:1-140.
  • Tan IL, Smith BR, von Geldern G, Mateen FJ, McArthur JC. HIV-associated opportunistic infections of the CNS. Lancet Neurol. 2012;11(7):605-617.
  • Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2010;50(3):291-322.
  • Byrnes EJ, 3rd, Bartlett KH, Perfect JR, Heitman J. Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals. Microbes Infect. 2011;13(11):895-907.
  • Graybill JR, Sobel J, Saag M, et al. Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. The NIAID Mycoses Study Group and AIDS Cooperative Treatment Groups. Clin Infect Dis. 2000;30(1):47-54.
  • In: Guidelines for The Diagnosis, Prevention and Management of Cryptococcal Disease in HIV-Infected Adults, Adolescents and Children: Supplement to the 2016 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Geneva2018.
  • European Guidelines for the treatment of HIV-positive adults in Europe. 2019. https://www.eacsociety.org/files/2019_guidelines-10.0_final.pdf.(10.0).
  • Shelburne SA, 3rd, Darcourt J, White AC, Jr., et al. The role of immune reconstitution inflammatory syndrome in AIDS-related Cryptococcus neoformans disease in the era of highly active antiretroviral therapy. Clin Infect Dis. 2005;40(7):1049-1052.
  • Govender NP, Meintjes G, Mangena P, et al. Southern African HIV Clinicians Society guideline for the prevention, diagnosis and management of cryptococcal disease among HIV-infected persons: 2019 update. South Afr J HIV Med. 2019;20(1):1030.
  • Spec A, Mejia-Chew C, Powderly WG, Cornely OA. EQUAL Cryptococcus Score 2018: A European Confederation of Medical Mycology Score Derived From Current Guidelines to Measure QUALity of Clinical Cryptococcosis Management. Open Forum Infect Dis. 2018;5(11):ofy299.


Einzelnachweise