title: Treatment of non-meningeal cryptococcosis in patients with AIDS. Centre d'Informations et de Soins de l'Immunodéficience Humaine de l'Est Parisien.
abstract: Amphotericin B, alone or combined with flucytosine, is the reference curative treatment for neuromeningeal cryptococcosis associated with the acquired immune deficiency syndrome (AIDS). Treatment of non-meningeal forms is less well standardized. Out of 75 human immunodeficiency virus (HIV)-infected patients with cryptococcosis, 16 had no meningeal involvement. One died before receiving any treatment, another received amphotericine B and recovered, and the remaining 14 received curative therapy with fluconazole (200-400 mg/day); 11 of the latter entered complete remission, while three deteriorated during the first week of treatment but recovered on amphotericin B combined, in two cases, with fluconazole. Only one relapse occurred during maintenance treatment with low-dose fluconazole (100 mg/day). No adverse effects of fluconazole treatment were observed. One of the patients on amphotericin B developed acute renal impairment requiring drug withdrawal. These results suggest that first-line fluconazole therapy is effective and well tolerated in patients with AIDS-associated non meningeal cryptococcosis.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Meyohas
authors.forename: J L
authors.initials: JL
authors.lastname: Meynard
authors.forename: D
authors.initials: D
authors.lastname: Bollens
authors.forename: P
authors.initials: P
authors.lastname: Roux
authors.forename: A M
authors.initials: AM
authors.lastname: Deluol
authors.forename: J L
authors.initials: JL
authors.lastname: Poirot
authors.forename: W
authors.initials: W
authors.lastname: Rozenbaum
authors.forename: C
authors.initials: C
authors.lastname: Mayaud
authors.forename: J
authors.initials: J
authors.lastname: Frottier
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D003453:Cryptococcosis / Q000188:drug therapy*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole