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Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens
09:57

Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens

Published on: February 15, 2011

A case of HIV-associated cerebral histoplasmosis successfully treated with fluconazole

S Knapp1, M Turnherr, G Dekan

  • 1Department of Internal Medicine I, University of Vienna Medical School, Austria.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|October 26, 1999
PubMed

Insights

Disseminated histoplasmosis with central nervous system involvement in HIV patients is rare and often fatal. High-dose fluconazole therapy led to rapid improvement and resolution of lesions in a documented case.

Area of Science:

  • Infectious Diseases
  • Neurology
  • HIV/AIDS Research

Background:

  • Disseminated histoplasmosis is a severe fungal infection, particularly concerning in immunocompromised individuals like those with HIV.
  • Central nervous system (CNS) involvement in disseminated histoplasmosis is uncommon but associated with high mortality, even with amphotericin B treatment.

Observation:

  • An HIV-infected patient presented with disseminated histoplasmosis, including miliary lung infiltrates and subsequent neurological deterioration with brain lesions.
  • Initial treatment with tuberculostatic agents was ineffective, highlighting the need for specific antifungal therapy.

Findings:

  • Histoplasma capsulatum was identified in lung biopsy and lavage fluid.
  • High-dose intravenous fluconazole (800 mg daily) resulted in rapid clinical improvement within 10 days.
  • Significant resolution of both pulmonary and cerebral mass lesions was observed following fluconazole therapy.

Implications:

  • This case suggests that high-dose fluconazole can be an effective treatment for disseminated histoplasmosis with CNS involvement in HIV-infected patients.
  • The findings challenge the traditional treatment paradigms and offer a potential alternative for this severe opportunistic infection.
  • Further research into fluconazole's efficacy and optimal dosing for CNS histoplasmosis in HIV is warranted.

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