Affordable Access

deepdyve-link
Publisher Website

Treatment of cryptococcal meningitis in Peruvian AIDS patients using amphotericin B and fluconazole.

Authors
  • Dammert, P1
  • Bustamante, B
  • Ticona, E
  • Llanos-Cuentas, A
  • Huaroto, L
  • Chávez, V M
  • Campos, P E
  • 1 Department of Medicine, John Stroger Jr. Hospital of Cook County, 1900 West Polk Street, Chicago, IL 60612, USA. [email protected]
Type
Published Article
Journal
The Journal of infection
Publication Date
Sep 01, 2008
Volume
57
Issue
3
Pages
260–265
Identifiers
DOI: 10.1016/j.jinf.2008.06.020
PMID: 18707764
Source
Medline
Language
English
License
Unknown

Abstract

To describe the mycologic and clinical outcomes and factors associated with failure in Peruvian patients with AIDS-associated cryptococcal meningitis (CM) treated with amphotericin B deoxycholate (Amph B) followed by fluconazole. Patients were treated with intravenous Amph B 0.7 mg/kg/day for 2 or 3 weeks followed by oral fluconazole 400mg/day for 7 or 8 weeks. Clinical and laboratory evaluations including cerebrospinal fluid (CSF) studies were performed at baseline and at weeks 2 and 10. The CSF cultures were negative in 25% and 68% of 47 patients at weeks 2 and 10, respectively. In the univariate analysis, baseline low body mass index (BMI), hyponatremia, low serum albumin, positive blood culture and CSF antigen titers >or=1024 were associated with a positive CSF culture at week 2. Baseline positive urine culture, positive blood culture, any positive extraneural culture and CSF opening pressure at week 2 >or=300 mm H2O were associated with a positive CSF culture at week 10. In the multivariate analysis no association was found. Therapy with Amph B and fluconazole, combined with aggressive management of elevated intracranial pressure (ICP), results in low CSF sterilization rates at week 2 and acceptable CSF sterilization rates at week 10 when compared with other series.

Report this publication

Statistics

Seen <100 times