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Posaconazole for chronic refractory coccidioidal meningitis

Rebecca Schein1, James Homans, Robert A Larsen

  • 1Maternal Child and Adolescent Center for Infectious Diseases and Virology, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. rschein@alumni.indiana.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 12, 2011
PubMed

Insights

Coccidioidal meningitis can be fatal, with fluconazole often failing. Posaconazole showed promise as an alternative treatment, improving symptoms and lab results in patients with chronic, treatment-resistant fungal meningitis.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Neurology

Background:

  • Coccidioidal meningitis is a severe fungal infection of the central nervous system.
  • Fluconazole resistance and treatment failure are significant challenges in managing this condition.
  • Limited safe and effective alternative therapies exist for refractory cases.

Observation:

  • Three patients with chronic, previously unresponsive coccidioidal meningitis were treated with posaconazole.
  • Two patients experienced symptomatic and laboratory improvements.
  • A third patient demonstrated clinical improvement.

Findings:

  • Posaconazole therapy was associated with positive clinical outcomes in patients with treatment-resistant coccidioidal meningitis.
  • The study suggests posaconazole may be a viable alternative for managing refractory cases.
  • Improvements were observed in both clinical status and laboratory markers of infection.

Implications:

  • Posaconazole represents a potential therapeutic option for patients with coccidioidal meningitis who fail standard treatments.
  • Further research is warranted to establish optimal dosing and long-term efficacy of posaconazole in this patient population.
  • This finding could lead to improved management strategies for this life-threatening fungal infection.

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