This article reports the diagnosis and treatment process of a patient with chronic liver failure accompanied by disseminated cryptococosis. The patient was confirmed to have cryptococcus neoformans infection through blood culture, cerebrospinal fluid and pleural effusion tests, which met the diagnosis of disseminated cryptococcosis. Clinical pharmacists are involved in the entire treatment process. During the induction period, it is recommended to use the antifungal regimen of amphotericin B combined with flucytosine, and the dosage should be dynamically adjusted based on liver and kidney functions (amphotericin B is gradually adjusted to 25 mg·d^-1). During the treatment, the patient developed elevated levels of serum creatinine and total bilirubin. It was promptly recommended to switch to fluconazole for consolidation treatment. Additionally, dosage adjustment suggestions were proposed for the drug interaction between fluconazole and tolvaptan (reducing the dosage of tolvaptan to 7.5 mg·d^-1). Eventually, the patient's infection indicators improved, and the condition was stable before discharge. This case indicates that in the treatment of liver failure complicated with disseminated cryptococcal infection, clinical pharmacists can participate in formulating and optimizing indi-vidualized antifungal regimens based on the patient's pathophysiological characteristics, the pharmacokinetic/pharmacodynamic (PK/PD) properties of antifungal drugs, and the latest guidelines, playing a key role in the management of polypharmacy and the prevention and control of adverse reactions.

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