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Cryptococcal meningitis in pregnancy.

C R Stafford, J F Fisher, H E Fadel

    Obstetrics and Gynecology
    |September 1, 1983
    PubMed
    Summary
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    This study monitored a pregnant woman with cryptococcal meningitis treated with amphotericin B and flucytosine. Fetal exposure to these antifungal drugs showed no signs of toxicity in developing fetal tissues.

    Area of Science:

    • Medical Mycology
    • Maternal-Fetal Medicine
    • Pharmacology

    Background:

    • Cryptococcal meningitis poses a significant risk during pregnancy.
    • Treatment options for pregnant women with fungal infections are limited.
    • Understanding drug transfer and fetal effects is crucial for optimizing maternal care.

    Observation:

    • A pregnant patient at 21 weeks' gestation was diagnosed with cryptococcal meningitis.
    • Therapy involved amphotericin B and flucytosine.
    • Fetal tissues, blood, and amniotic fluid were analyzed post-treatment.

    Findings:

    • Amphotericin B and flucytosine concentrations were measured in amniotic fluid and cord blood.
    • Specific drug concentrations were: Amphotericin B (0.25 µg/ml amniotic fluid, 0.3 µg/ml cord blood) and Flucytosine (168 µg/ml amniotic fluid, 64.7 µg/ml cord blood).

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  • No evidence of toxicity was observed in fetal tissues despite drug exposure.

    • Implications:

    • This case provides valuable data on the transplacental transfer of amphotericin B and flucytosine.
    • Findings suggest a potential safety profile for these antifungals in fetal development during brief exposure.
    • Further research is warranted to confirm long-term fetal outcomes and refine treatment protocols.