Cryptococcosis in AIDS patients: observations concerning CNS involvement

Weinke, T.; Rögler, Gertrud; Sixt, C.; Matos-Marques, B. de; Pohle, H. D.; Staib, F.; Seibold, Michael

doi:10.1007/bf00314216

Cited by 19 publications

(3 citation statements)

References 38 publications

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“…Die Standardtherapeutika in der Cryptococcose sind Amphotericin B und Flucytosin, wobei eine Monotherapie mit Amphotericin B und/oder eine Kombination aus Amphotericin B und Flucytosin eingesetzt werden [4,6,11,12].…”

Section: Thera Pieunclassified

Cryptococcosis with AIDS: therapeutic strategies

Ruf

1990

Mycoses

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Cryptococcosis is the most common life-threatening mycosis with AIDS. The combination therapy based on amphotericin B and flucytosine is furthermore the therapy of first choice, even after introduction of fluconazole. With a therapy maintained over a period of 6 weeks the combination is nearly always successful; a shorter treatment period leads to minor treatment success. Since no elimination of the pathogen is possible in cryptococcosis with AIDS a permanent relapse prevention is necessary. In this prevention strategy fluconazole is highly effective and at present the drug of first choice; it is as effective as amphotericin B. An additional advantage is the possibility of oral application.

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Section: Thera Pieunclassified

Cryptococcosis with AIDS: therapeutic strategies

Ruf

1990

Mycoses

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“…It is of interest that in AIDS patients, the CSF cell count as well as protein and glucose levels may be normal or slightly abnormal, whereas in non-AIDS patients suffering from Cr. neoformans meningitis, these CSF indices are mostly abnormal [7,20]. In non-AIDS patients the involvement of the meninges in cryptococcosis can take place in a chronic course over years [2,4,25], Whereas in AIDS patients, the occurrence of Cr.…”

Section: Occurrence Of Cr Neoformans In the Csf Of Non-aids And Aidsmentioning

confidence: 99%

“…neoformans CFU count in CSF, 10 6 I ml. CSF indices: Leucocytes 3 I 3; protein 28 mgl dl; glucose 22 mgl dl (glucose in serum 63 mgl dl) [20].…”

Section: Occurrence Of Cr Neoformans In the Csf Of Non-aids And Aidsmentioning

confidence: 99%

Cerebrospinal fluid indices in cryptococcal and tuberculous meningitis: The spider web coagulum and its diagnostic significance

Staib

Seibold²,

Antweiler³

et al. 1990

Mycoses

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The differentiation between a chronic cryptococcal meningitis and a chronic tuberculous meningitis may cause problems for the clinician only if standard microbiological methods are not applied to the diagnosis of both infections. In a male non-AIDS patient (50 y), 11 years after a suggested diagnosis of "tuberculous meningitis", meningoencephalitis with hydrocephalus was diagnosed and treated accordingly without success. Mycobacterium tuberculosis was never found. Because fibrin fibres of a spider web coagulum in the CSF resembled Aspergillus mycelium, the patient was then treated with amphotericin B + flucytosine. Finally, a mycological examination led to the true diagnosis: (1) In the CSF, resembling Aspergillus hyphae were found to be spider web coagulum fibres. (2) Cryptococcal meningoencephalitis based on the detection of Cryptococcus neoformans in CSF and its antigen in serum and CSF. - At post-mortem, cryptococcal meningoencephalitis was established as cause of death. Residual signs of tuberculosis could not be detected in the brain and the meninges. Common clinical similarities of cryptococcal and tuberculous meningitis and the possibility of a double infection are discussed. A comparison of the presence of Cr. neoformans in the meninges of non-AIDS and AIDS patients is made. The formation of spider web coagulum in the CSF is discussed. Proposals for the diagnosis, therapy and prophylaxis of cryptococcal meningitis are made.

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M

Woolliscroft

2001

Current Diagnosis &Amp; Treatment

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Cryptococcosis in AIDS patients: observations concerning CNS involvement

Cited by 19 publications

References 38 publications

Cryptococcosis with AIDS: therapeutic strategies

Cryptococcosis with AIDS: therapeutic strategies

Cerebrospinal fluid indices in cryptococcal and tuberculous meningitis: The spider web coagulum and its diagnostic significance

M

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