Figure 1. Non-Meningeal Cryptococcosis
Mild-to-Moderate
Disease
Severe Pulmonary
Diseasea
Nonpulmonary
Cryptococcemia
No Fungemia, Single Site
of Infection, and No
Immunosuppressive
Risk Factors
Treatment:
Fluconazole (400 mg per day)
Duration: 6-12 months, B-III
Treatment:
Same as CNS disease
Duration: 12 months, B-III
Treatment:
Fluconazole 400 mg per day
Duration: 6-12 months, B-III
Induction Therapy:
Cerebral
Cryptococcomas
AmBd (0.7-1.0 mg/kg per day IV),
liposomal AmB (3-4 mg/kg per day IV),
or ABLC (5 mg/kg per day IV)
PLUS flucytosine (100 mg/kg per day
orally in 4 divided doses)
Duration: ≥ 6 weeks, B-III
Consolidation and Maintenance:
Fluconazole (400-800 mg per day orally)
Duration: 6-18 months, B-III
Induction Therapy:
Children with CNS and
Disseminated Disease
AmBd (1 mg/kg per day IV) or
liposomal AmB (5 mg/kg per day)b or
ABLC (5 mg/kg per day)b
PLUS flucytosine (100 mg/kg per day
orally in 4 divided doses)
Duration: 2 weeks
Consolidation:
Fluconazole (10-12 mg/kg per day orally)
Duration: ≥ 8 weeks, B-III
Maintenance:
Fluconazole (6 mg/kg per day orally)
Duration: ≥ 12 months, B-II
Children with
Cryptococcal
Pneumonia
a
b
Treatment:
Fluconazole (6-12 mg/kg per day orally)
Duration: ≥ 12 months, B-II
In immunosuppressed patients, directly rule out CNS disease with lumbar puncture.
For AmB-intolerant patients.
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