Overview of human cryptococcosis: from cryptococcal species taxonomy to management

Abstract

Seven Cryptococcus species are currently recognized as responsible for human cryptococcosis. Around a century after it was first observed, neuro-meningeal cryptococcosis (NMC) has become a global health threat with the emergence of the HIV/AIDS pandemic. Although HIV infection is the main risk factor for cryptococcosis, several other comorbidities have also been identified as independent risk factors (decompensated liver cirrhosis, autoimmune diseases, solid organ transplants, etc.). Here, we present an overview of human cryptococcosis in the current state of knowledge. On the basis of clinical expression of the neurological form of the disease and the appropriate management of patients, the distinction between immune reconstitution inflammatory syndrome (IRIS) due to NMC (IRIS-NMC) and persistent and recurrent infections remains crucial. Diagnosis of cryptococcosis has considerably improved over the years, thanks to highly accurate identification procedures such as mass spectrometry and molecular biology techniques. The management of cryptococcosis relies on both medicinal and non-medicinal means, likely to improve the patient's clinical condition. These means include the administration of antifungal agents and measures to combat life-threatening complications such as intracranial hypertension and IRIS-NMC. Received: March 20th, 2025 Accepted: June 14th, 2025 https://dx.doi.org/10.4314/aamed.v18i4.18