Résumé

• An invasive opportunistic fungal infection predominantly seen in immunocompromised patients, although immunocompetent hosts may also be affected.
• The lungs are generally the primary locus of infection, with extrapulmonary dissemination affecting the meninges and, less commonly, the skin, bones, prostate, and other organs.
• Microbiology, serum antigen levels, and histopathology are required to make the diagnosis.
• Meningoencephalitis is life-threatening, particularly in immunosuppressed patients.
• Unrecognised and untreated cryptococcosis can be fatal, especially in immunocompromised patients.
• Treatment depends on the immunological state and disease severity. For asymptomatic and mild to moderate disease with no central nervous system (CNS) involvement, oral fluconazole is the first-line treatment. Amphotericin induction followed by a course of fluconazole is recommended for severe disease and CNS involvement.
• Primary prophylaxis with either itraconazole or fluconazole is effective in reducing the incidence of cryptococcal disease in adults with HIV (CD4 <100 cells/microlitre), but there is no clear effect on overall mortality.