Last reviewed: November 2017
Last updated: January  2017

Summary

Definition

History and exam

Key diagnostic factors

  • constitutional symptoms
  • dyspnea
  • productive cough
  • dullness to percussion
  • diminished breath sounds
  • crackles
  • headache
  • alteration of consciousness
  • coma
  • meningeal irritation
  • papilledema
  • skin lesions

Other diagnostic factors

  • chest pain
  • cranial neuropathy
  • ocular manifestations

Risk factors

  • HIV infection
  • immunosuppression
  • comorbidities and smoking
  • exposure to Cryptococcus species
  • male gender
  • pregnancy and postpartum period

Diagnostic investigations

1st investigations to order

  • cryptococcal antigen lateral flow assay
  • serum cryptococcal polysaccharide antigen (sCRAG)
  • CSF CRAG
  • pleural fluid CRAG
  • cultures
  • HIV antibodies
  • CXR
  • lumbar puncture
  • CSF microscopy
  • white blood cell count (cells/microliter)
Full details

Investigations to consider

  • CT chest
  • MRI brain
  • CT brain
  • bronchoscopy
  • biopsy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Respiratory Consultant

Royal Infirmary

Edinburgh

Scotland

UK

Disclosures

RLR declares that she has no competing interests.

Respiratory Physician

Royal Infirmary

Edinburgh

Scotland

UK

Disclosures

ADP declares that she has no competing interests.

Peer reviewers VIEW ALL

Consultant

Muñiz Hospital

Honorary Professor

University of Buenos Aires

Buenos Aires

Argentina

Disclosures

RN declares that he has no competing interests.

Assistant Professor of Medicine

Division of Infectious Diseases and International Health

Duke University Medical Center

Durham

NC

Disclosures

AZ has received research funding from Enzon Pharmaceuticals and has been on the speaker's bureau for Astellas Pharma and Pfizer Inc.

Clinical Lecturer/Wellcome Trust Fellow

Centre for Infection

Division of Cellular and Molecular Medicine

St. George's University

London

UK

Disclosures

JJ declares that he has no competing interests.

Distinguished Assistant Professor

Center for Infectious Diseases and Microbiology Translational Research

University of Minnesota

Minneapolis

MN

Disclosures

DRB declares that he has no competing interests.

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