{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:41:05Z","timestamp":1791265265085,"version":"4.1.0"},"reference-count":63,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2024,5,27]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Cryptococcal meningitis is an important global health problem, resulting from infection with the yeast <jats:italic>Cryptococcus<\/jats:italic>, especially <jats:italic>Cryptococcus neoformans<\/jats:italic> and <jats:italic>Cryptococcus gattii<\/jats:italic>, which cause a spectrum of disease ranging from pulmonary and skin lesions to life-threatening central nervous system involvement. The diagnosis and management of cryptococcal meningitis have substantially changed in recent years. Cryptococcal meningitis often occurs in people living with advanced HIV infection, though in high-income countries with robust HIV detection and treatment programmes, it increasingly occurs in other groups, notably solid-organ transplant recipients, other immunosuppressed patients and even immunocompetent hosts. This review outlines the clinical presentation, management and prognosis of cryptococcal meningitis, including its salient differences in people living with HIV compared with HIV-negative patients. We discuss the importance of managing raised intracranial pressure and highlight the advantages of improved multidisciplinary team working involving neurologists, infectious disease specialists and neurosurgeons.<\/jats:p>","DOI":"10.1136\/pn-2024-004133","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T13:20:20Z","timestamp":1720790420000},"page":"25-39","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Reframing the clinical phenotype and management of cryptococcal meningitis"],"prefix":"10.1136","volume":"25","author":[{"given":"Maria Francisca","family":"Rocha","sequence":"first","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish D C","family":"Bain","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Stone","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Meya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Darie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed K","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3174-6027","authenticated-orcid":false,"given":"Michael P T","family":"Lunn","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5715-5025","authenticated-orcid":false,"given":"Arpan R","family":"Mehta","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"MRC Protein Phosphorylation & Ubiquitylation Unit, School of Life Sciences, University of Dundee, Dundee, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3907-3859","authenticated-orcid":false,"given":"Charles","family":"Coughlan","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"2025090409520842000_25.1.25.1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(22)00499-6"},{"key":"2025090409520842000_25.1.25.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8"},{"key":"2025090409520842000_25.1.25.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004429","article-title":"Funding and innovation in diseases of neglected populations: the paradox of cryptococcal meningitis","volume":"10","author":"Rodrigues","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"2025090409520842000_25.1.25.4","doi-asserted-by":"publisher","DOI":"10.3201\/eid1405.071312"},{"key":"2025090409520842000_25.1.25.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2016.10.005"},{"key":"2025090409520842000_25.1.25.6","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro.2015.6"},{"key":"2025090409520842000_25.1.25.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.10.006"},{"key":"2025090409520842000_25.1.25.8","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00126-13"},{"key":"2025090409520842000_25.1.25.9","doi-asserted-by":"publisher","DOI":"10.3109\/13693780903437876"},{"key":"2025090409520842000_25.1.25.10","doi-asserted-by":"publisher","DOI":"10.1086\/322597"},{"key":"2025090409520842000_25.1.25.11","doi-asserted-by":"crossref","unstructured":"Lee E , Miller C , Ataya A , et al . 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