S52(5) Cryptococcus

Question 1

Cryptococcus is an encapsulated yeast

common in pidgeon droppings

Answer 1

True

Question 2

Cryptococcus therapy

Answer 2

Echinocandins have NO in vivo activity

Question 3

Cryptococcal Meningoencephalitis induction therapy

Answer 3

AmB liposomal 3-4mg/kg/day + flucytosine 100mg/kg/day in 4 divided doses

2 wks in HIV, 4 wks in non-HIV and non-SOT

Question 4

Cryptococcal Meningoencephalitis Consolidation therapy

Answer 4

Fluconazole 6mg/kg/day x 8 wks

Question 5

Cryptococcal Meningoencephalitis maintenance (suppressive) therapy

Answer 5

Fluconazole 200mg PO qDay
Itraconazole 200mg PO q12h
AmB can be used but is less effective than triazoles

Question 6

Cryptococcal Meningoencephalitis - Wait to initiate ART x 2-10wks after initiation of antifungals or risk IRIS

Answer 6

True

Question 7

Cryptococcal Meningoencephalitis
Discontinue suppressive therapy
CD4 > 100 cells/µL

Answer 7

True

Question 8

Pulmonary Cryptococcosis
Mild to moderate: Fluconazole 400mg PO x 6-12 months
Severe: treat like CNS disease (Liposomal Amp)

Answer 8

True