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. 2023 Sep 15;9(9):932. doi: 10.3390/jof9090932

Table 3.

Co-infections with Cryptococcus.

Pathogens Underlying Disease Specimen of
Co-Infectants		 Specimens
of Cryptococcus 		Treatment Strategy Treatment
for Cryptococcus 		Treatment
for Co-Infectants		 Outcome
Pneumocystis jiroveci [30] AIDS * BAL 1 BAL 2 and Blood 2 Pneumocystis jiroveci, then ART, then asymptomatic cryptococcus Voriconazole Cotrimoxazol Complete resolution of the cavitation
Non-tuberculous Mycobacteria [31] AIDS, syphilis Sputum/BAL 1 (CMV, EBV, Candida albicans also detected) Blood 2 Treat NTM only because the culture results are later than the patient’s discharge No treatment Trimethoprim-sulfamethoxazole and steroids Not mentioned
Mycobacterium avium complex [32] AIDS Lymph node biopsy 2 Blood 1 and * CSF 1 Treat Cryptococcus first, then ART, then MAC Amphotericin B and flucytosine then fluconazole Azithromycin, ethambutol and rifabutin Good clinical evolution
Histoplasmosis [33] AIDS Lymph node biopsy Blood and Sputum HARRT then treat Cryptococcus infection Amphotericin B and flucytosine then fluconazole Continue * ART and Fluconazole
T. marneffei AIDS [34] Skin papules culture * CSF HARRT and treat Cryptococcus infection Amphotericin B then itraconazole Not mentioned Skin papule disappeared and
Continue * HAART therapy
Hemolytic anemia with 8-year steroid history [35] Blood 1 and lymph node aspiration Blood culture 2 Voriconazole for T. marneffei and Cryptoccocus Voriconazole Voriconazole Discharged with oral voriconazole
Aspergillus
[36]		 Multiple myeloma * BAL 2 Pulmonary infection 1, not mentioned about the specimen Treat Cryptococcus first then Aspergillus Amphotericin B and flucytosine, then fluconazole Fluconazole was shifted to voriconazole for additional coverage Discharged with oral voriconazole
Mycobacterium tuberculosis [37] No remarkable history Transbronchial
biopsy specimen from RUL lung and Sputum 1 		* BAL 1 & CSF 2 combination of anti-TB
and antifungal therapy		 Amphotericin B
and flucytosine then fluconazole		 Isoniazid+ rifampin+pyrazinamide+ ethambutol Hold fluconaconazole for nephrotoxicity;
Discharged
Mycobacterium abscessus [38] Lupus nephritis and 10-year corticosteroid history Sputum Sputum Patient refused inpatient care Itraconazole Clarithromycin and faropenem No recurrence was observed

* BAL: Bronchial-alveolar lavage; CSF: Cerebrospinal fluid; HAART: Highly Active Anti-Retroviral Therapy; ART: Anti-Retroviral Therapy. 1: Specimens at initial diagnosis. 2: Specimens with subsequent pathogen detection.