Cryptococcosis

HIV-positive patients receiving antiretroviral treatment should be aware of deterioration or changes in their clinical status and seek medical attention if symptoms such as a persistent mild headache or nausea occur.

Effective birth control measures should be recommended to all HIV-infected women on azole therapy for cryptococcosis. In women who conceive while receiving primary prophylaxis and wish to continue the pregnancy, discontinuation of this prophylaxis should be considered due to the teratogenic effects of fluconazole. If the criteria for the discontinuation of secondary prophylaxis (chronic maintenance therapy) are met, cessation of treatment should be strongly considered during pregnancy if the CD4 count is >100 to 200 cells/mm³.[82]Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. April 2022 [internet publication]. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-oi/guidelines-adult-adolescent-oi.pdf

Patients with pulmonary cryptococcosis should be advised that there is no need for isolation as no cases of person-to-person transmission via the respiratory route have been reported.