Pneumonia Fúngica e Criptococose: Revisão Abrangente dos Desafios Diagnósticos, Abordagens Terapêuticas e Impactos Clínicos em Populações Imunocomprometidas

Abstract

Introduction: Fungal pneumonia is a severe lung infection that frequently affects immunocompromised patients, such as those with HIV/AIDS, organ transplant recipients, or individuals on immunosuppressive therapy. Among fungal infections, cryptococcosis, caused by Cryptococcus neoformans, stands out due to its high morbidity and mortality. Early diagnosis and appropriate treatment are essential to improve clinical outcomes. However, identifying these infections is often challenging due to the nonspecificity of symptoms and limitations of conventional diagnostic methods. Objective: This article aims to review the main diagnostic challenges and therapeutic approaches for fungal pneumonia and cryptococcosis, with an emphasis on clinical impacts in immunocompromised populations. Methodology: A literature review was conducted in scientific databases such as PubMed and Scielo, using terms like "fungal pneumonia," "cryptococcosis," "diagnosis," "treatment," "immunocompromised population," and "fungal infection." Articles published in the last 10 years were selected, focusing on diagnostic, therapeutic aspects, and clinical impacts of these diseases in immunocompromised patients. Discussion/Results: Diagnostic challenges include the lack of specific symptoms, which often overlap with those of other lung diseases, such as tuberculosis and bacterial pneumonias. Confirming the diagnosis frequently requires specialized laboratory methods, such as fungal culture, cryptococcal antigen testing, and polymerase chain reaction (PCR). However, these techniques have limitations, particularly in the early stages of infection or in cases of low fungal load. Regarding treatment, antifungals such as amphotericin B, fluconazole, and voriconazole are commonly used, but their efficacy varies according to the patient’s immunological status and the speed of therapy implementation. Clinical management in immunocompromised populations requires a multidisciplinary approach, including rigorous monitoring and continuous therapeutic adjustments to minimize complications and improve survival. Conclusion: Fungal pneumonia and cryptococcosis represent significant clinical challenges, especially in immunocompromised patients. Early diagnosis and effective treatment are crucial for improving outcomes, but the limitations of current methods highlight the need for developing new diagnostic and therapeutic technologies. A multidisciplinary approach is essential to optimize the care of these vulnerable patients.