ID 110874
Author
Sasakawa, Atsushi AIDS Medical Center, National Hospital Organization, Osaka National Hospital
Yamamoto, Yoshihiko AIDS Medical Center, National Hospital Organization, Osaka National Hospital
Yajima, Keishiro AIDS Medical Center, National Hospital Organization, Osaka National Hospital
Sakai, Mio Department of Radiology, National Hospital Organization, Osaka National Hospital
Uehira, Tomoko AIDS Medical Center, National Hospital Organization, Osaka National Hospital
Shirasaka, Takuma AIDS Medical Center, National Hospital Organization, Osaka National Hospital
Makie, Toshio AIDS Medical Center, National Hospital Organization, Osaka National Hospital
Keywords
AIDS-related opportunistic infections
cryptococcus
immune reconstitution syndrome (IRS)
liposomal amphotericin B
Content Type
Journal Article
Description
We examined the efficacy of liposomal amphotericin B (L-AMB) for intractable cryptococcal meningoencephalitis in a patient with acquired immunodeficiency syndrome (AIDS) and the presence of immune reconstitution syndrome (IRS) caused by the treatment. A 34-year-old patient presented with meningitis. Cryptococcal organisms were detected microscopically in the cerebrospinal fluid (CSF) with Indian ink staining, and were then cultured from the CSF. Initial treatment with amphotericin B and flucytosine (5-FC) or voriconazole and/or fluconazole failed to eradicate cryptococcal organisms from the CSF. Secondary treatment with L-AMB and 5-FC following seven months of antiretroviral therapy was successful. Simultaneously, treatment with L-AMB caused severe brain edema likely due to IRS. There were large differences in immune function improvement and liposomalization of the fungicide between the initial and secondary treatments. In conclusion, differences in immune status should be considered when administering L-AMB, in order to prevent IRS-related complications.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
55
Issue
3-4
Start Page
292
End Page
296
Sort Key
292
Published Date
2008-08
FullText File
language
eng
TextVersion
Publisher