| Liposomal amphotericin B for a case of intractable cryptococcal meningoencephalitis and immune reconstitution syndrome. | |
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MedLine Citation:
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PMID: 18797146 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We examined the efficacy of liposomal amphotericin B (L-AMB) for intractable cryptococcal meningoencephalitis in a patient with acquired immunodeficiency syndrome (AIDS) and the presence of immune reconstitution syndrome (IRS) caused by the treatment. A 34-year-old patient presented with meningitis. Cryptococcal organisms were detected microscopically in the cerebrospinal fluid (CSF) with Indian ink staining, and were then cultured from the CSF. Initial treatment with amphotericin B and flucytosine (5-FC) or voriconazole and/or fluconazole failed to eradicate cryptococcal organisms from the CSF. Secondary treatment with L-AMB and 5-FC following seven months of antiretroviral therapy was successful. Simultaneously, treatment with L-AMB caused severe brain edema likely due to IRS. There were large differences in immune function improvement and liposomalization of the fungicide between the initial and secondary treatments. In conclusion, differences in immune status should be considered when administering L-AMB, in order to prevent IRS-related complications. |
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Authors:
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Atsushi Sasakawa; Yoshihiko Yamamoto; Keishiro Yajima; Mio Sakai; Tomoko Uehira; Takuma Shirasaka; Toshio Makie |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The journal of medical investigation : JMI Volume: 55 ISSN: 1349-6867 ISO Abbreviation: J. Med. Invest. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-09-17 Completed Date: 2009-01-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9716841 Medline TA: J Med Invest Country: Japan |
Other Details:
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Languages: eng Pagination: 292-6 Citation Subset: IM |
Affiliation:
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AIDS Medical Center; National Hospital Organization, Osaka National Hospital, Osaka, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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AIDS-Related Opportunistic Infections
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complications*,
drug therapy*,
immunology Adult Amphotericin B / administration & dosage*, adverse effects Antifungal Agents / administration & dosage*, adverse effects Antiretroviral Therapy, Highly Active / adverse effects Female Humans Immune Reconstitution Inflammatory Syndrome / complications*, etiology, immunology, prevention & control Liposomes Meningitis, Cryptococcal / complications*, drug therapy*, immunology |
| Chemical | |
Reg. No./Substance:
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0/Antifungal Agents; 0/Liposomes; 1397-89-3/Amphotericin B |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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