Case Report. Recurrence of increased intracranial pressure with antiretroviral therapy in an AIDS patient with cryptococcal meningitis

被引:24
作者
Cinti, SK [1 ]
Armstrong, WS [1 ]
Kauffman, CA [1 ]
机构
[1] Univ Michigan, Sch Med, Vet Affairs Ann Arbor Healthcare Syst, Div Infect Dis, Ann Arbor, MI USA
关键词
cryptococcosis; meningitis; AIDS; HAART; intracranial pressure;
D O I
10.1046/j.1439-0507.2001.00663.x
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
We present the case of an AIDS patient with cryptococcal meningitis who, after an excellent clinical and mycological response to antifungal therapy, developed an exacerbation of signs and symptoms, including elevated intracranial pressure and an increase in cerebrospinal fluid cryptococcal antigen and white blood cells, following the initiation of highly active antiretroviral therapy (HAART). Cultures yielded no growth and the patient responded to repeated lumbar punctures without changing or intensifying antifungal therapy. To our knowledge, this is the first report of symptomatic elevated intracranial pressure occurring during HAART-related immune recovery in a patient with cryptococcal meningitis. Exacerbation of symptoms does not necessarily reflect mycological failure that requires a change in antifungal therapy, but may relate to acutely increased intracranial pressure that will respond to simple measures, such as repeated lumbar punctures.
引用
收藏
页码:497 / 501
页数:5
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