Document Detail


A case of HIV-associated cerebral histoplasmosis successfully treated with fluconazole.
MedLine Citation:
PMID:  10534189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clinically apparent involvement of the central nervous system is a rare event in cases of disseminated histoplasmosis, even in HIV-infected persons. Despite therapy with amphotericin B, mortality remains very high. Reported here is the case of an HIV-infected patient with a 3-month history of fever, cough, weight loss and miliary lung infiltrates. Four weeks after initiation of tuberculostatic therapy, high-grade fever, neurological symptoms, personality changes and respiratory deterioration occurred. Magnetic resonance imaging of the brain showed multiple mass lesions, and a chest radiograph revealed worsening of pulmonary infiltrates. Methenamine silver staining of a lung biopsy specimen demonstrated Histoplasma capsulatum. Subsequently, this pathogen was cultured from lavage fluid. Following high-dose intravenous fluconazole therapy (800 mg once daily), the patient's condition improved markedly within 10 days, followed by an almost complete resolution of pulmonary and cerebral mass lesions. This is believed to be the first documented case of rapid improvement of disseminated histoplasmosis with central nervous system involvement in an HIV-infected patient upon induction of therapy with fluconazole.
Authors:
S Knapp; M Turnherr; G Dekan; B Willinger; G Stingl; A Rieger
Related Documents :
12451289 - Monitoring adverse drug reactions to sulfonamide antibiotics in human immunodeficiency ...
1763619 - Air embolism due to pulmonary barotrauma in a patient undergoing cesarean section.
9522969 - The demography, clinical manifestations and natural history of human immunodeficiency v...
8078369 - Pneumonia in patients with hiv infection.
6325849 - Opportunistic infection complicating acquired immune deficiency syndrome. clinical feat...
8879789 - Management and outcome of pneumothoraces in patients infected with human immunodeficien...
11684929 - Discontinuation of potent antiretroviral therapy: predictive value of and impact on cd4...
12472959 - Management of ymdd mutations during lamivudine therapy in patients with chronic hepatit...
2345809 - The spleen in hiv infection--morphological evidence of hiv-associated macrophage dysfun...
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  18     ISSN:  0934-9723     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-17     Completed Date:  1999-11-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  658-61     Citation Subset:  IM; X    
Affiliation:
Department of Internal Medicine I, University of Vienna Medical School, Austria.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / drug therapy*
Adult
Antifungal Agents / therapeutic use*
Brain Diseases / drug therapy*
Central Nervous System Fungal Infections / drug therapy*
Fluconazole / therapeutic use*
Histoplasmosis / drug therapy*
Humans
Male
Chemical
Reg. No./Substance:
0/Antifungal Agents; 86386-73-4/Fluconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Infective endocarditis due to Fusobacterium nucleatum in an intravenous drug abuser.
Next Document:  A case of disseminated histoplasmosis likely due to infection from a liver allograft.