Consensus guidelines for the diagnosis and management of cryptococcosis and rare yeast infections in the haematology/oncology setting, 2021

Christina C Chang; Victoria Hall; Celia Cooper; George Grigoriadis; Justin Beardsley; Tania C Sorrell; Christopher H Heath; and the Australasian Antifungal Guidelines Steering Committee

doi:10.1111/imj.15590

Consensus guidelines for the diagnosis and management of cryptococcosis and rare yeast infections in the haematology/oncology setting, 2021

Intern Med J. 2021 Nov:51 Suppl 7:118-142. doi: 10.1111/imj.15590.

Authors

Christina C Chang^{1

2

3}, Victoria Hall^{1

4}, Celia Cooper⁵, George Grigoriadis^{6

7

8

9}, Justin Beardsley^{10

11

12}, Tania C Sorrell^{10

13

14}, Christopher H Heath^{15

16

17

18}; and the Australasian Antifungal Guidelines Steering Committee

Collaborators

and the Australasian Antifungal Guidelines Steering Committee:
Monica A Slavin, Karin A Thursky, Jason A Roberts, Leon J Worth, Christina C Chang, Sharon C-A Chen, C Orla Morrissey, Christopher C Blyth, Anna Khanina

Affiliations

¹ Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
² Therapeutic and Vaccine Research Programme, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
³ Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, KwaZulu Natal, South Africa.
⁴ Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.
⁵ Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
⁶ Monash Haematology, Monash Health, Melbourne, Victoria, Australia.
⁷ School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.
⁸ Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, Victoria, Australia.
⁹ Department of Haematology, Alfred Hospital, Prahran, Victoria, Australia.
¹⁰ Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney, Sydney, New South Wales, Australia.
¹¹ Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
¹² Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia.
¹³ Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, New South Wales, Australia.
¹⁴ Infectious Diseases and Sexual Health, Western Sydney Local Health District, Parramatta, New South Wales, Australia.
¹⁵ Department of Microbiology, Fiona Stanley Hospital Network, PathWest Laboratory Medicine, Murdoch, Western Australia, Australia.
¹⁶ Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
¹⁷ Department of Infectious Diseases, Royal Perth Hospital, Perth, Western Australia, Australia.
¹⁸ Faculty of Health and Medical Sciences, University of Western Australia, Murdoch, Western Australia, Australia.

PMID: 34937137
DOI: 10.1111/imj.15590

Abstract

Cryptococcosis caused by the Cryptococcus neoformans-Cryptococcus gattii complex is an important opportunistic infection in people with immunodeficiency, including in the haematology/oncology setting. This may manifest clinically as cryptococcal meningitis or pulmonary cryptococcosis, or be detected incidentally by cryptococcal antigenemia, a positive sputum culture or radiological imaging. Non-Candida, non-Cryptococcus spp. rare yeast fungaemia are increasingly common in this population. These consensus guidelines aim to provide clinicians working in the Australian and New Zealand haematology/oncology setting with clear guiding principles and practical recommendations for the management of cryptococcosis, while also highlighting important and emerging rare yeast infections and their recommended management.

Keywords: C. gattii; Cryptococcus spp.; cryptococcal meningitis; cryptococcosis; immune reconstitution inflammatory syndrome.

MeSH terms

Australia / epidemiology
Cryptococcosis* / diagnosis
Cryptococcosis* / drug therapy
Cryptococcus gattii*
Cryptococcus neoformans*
Hematology*
Humans
Saccharomyces cerevisiae