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Published on: February 27, 2018

Meningitis due to Cryptococcus neoformans: treatment with posaconazole

Veronica G Flores1, Rosa M Cervantes Tovar, Patricia G Zaldivar

  • 1Hospital de Infectología, CMN La Raza, México, D.F., Mexico. vgaona2@yahoo.com.mx

Current HIV Research
|August 10, 2012
PubMed
Abstract

Insights

Posaconazole shows promise for treating cryptococcal meningitis in AIDS patients. This study found posaconazole effective in clearing the infection and improving symptoms, offering an alternative for central nervous system fungal infections.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Cryptococcus neoformans central nervous system (CNS) infections are opportunistic, posing high mortality risks in immunocompromised individuals, particularly those with AIDS.
  • Standard treatments like Amphotericin B deoxycholate and fluconazole have limitations due to intolerance and potential drug resistance.
  • Posaconazole, an azole antifungal, presents a potential alternative with a favorable adverse event profile.

Purpose of the Study:

  • To evaluate the clinical and microbiological efficacy of posaconazole in patients with CNS infections caused by Cryptococcus neoformans.
  • To describe the characteristics and treatment response of posaconazole use in this patient population.

Main Methods:

  • A case study design was employed.
  • Eight patients diagnosed with AIDS and cryptococcal meningitis were included.
  • Seven patients received oral posaconazole at 800 mg daily for 28 days.

Main Results:

  • Cerebrospinal fluid (CSF) cultures became negative for C. neoformans by the second week of treatment.
  • Patients experienced significant improvement in CNS symptoms, including reduced headache, fever, and visual disturbances.
  • Enhanced alertness and environmental awareness were observed in treated patients.

Conclusions:

  • Central nervous system fungal infections predominantly affect immunocompromised hosts.
  • The emergence of antifungal resistance is a concern with systemic antifungal agent use.
  • Posaconazole appears to be a viable alternative for treating fungal CNS infections caused by C. neoformans.

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