Cryptococcosis in hiv-infected and non-hiv-infected hosts

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Cryptococcosis remains an important cause of morbidity and mortality in HIV infected and non HIV-infected immunosuppressed hosts. Risk factors for cryptococcal meningitis remain poorly defined, but the use of fluconazole has been associated with decreased rates of infection in HIV-infected persons. Clinical presentation may be nonspecific, but an abnormal mental status is predictive of a poor outcome and is frequently related to elevated cerebrospinal fluid pressures. Aggressive management of elevated cerebrospinal fluid pressures, often requiring frequent large volume spinal taps, improves outcome. Standard doses of amphotericin (0.7 mg/kg/d) with or without flucytosine for 2 weeks, followed by fluconazole or itraconazole at 400 mg/d is a successful therapeutic regimen. Compliant patients with the absence of high risk factors can be treated in some cases with fluconazole alone in doses of 400 mg/d or more. Suppressive therapy with fluconazole is required in persistently immunosuppressed patients to prevent relapse. Regimens of higher doses of fluconazole, new agents, liposomal forms of amphotericin B or combination antifungal therapy may be required for relapse. Fluconazole at 200 mg/d prevents cryptococcal infection, but evaluation of intermittent fluconazole prophylaxis regimens is in progress.

Original languageEnglish (US)
Pages (from-to)S64-S69
JournalInternational Journal of Infectious Diseases
Volume1
Issue numberSUPPL. 1
StatePublished - Jul 1 1997

Keywords

  • AIDS
  • Cryptococcosis
  • Fluconazole
  • Meningitis
  • amphotericin B

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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