The management of cryptococcal meningitis in Papua New Guinea.
Cryptococcal meningitis is a difficult disease to treat and requires biochemical and haematological monitoring to detect the common adverse effects of treatment. Combination therapy with amphotericin B and flucytosine for at least 6 weeks is the best treatment so far evaluated. The role of azole drugs should become clearer as the results of large multicentre studies become available in the future. High case fatality and morbidity rates despite standard treatment suggest that other ancillary treatments such as corticosteroids and other treatments directed at lowering raised intracranial pressure may also be required in some patients.
Seaton
R A
RA
Department of Clinical Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002423:Cause of Death; D004338:Drug Combinations; D016903:Drug Monitoring; D015725:Fluconazole / Q000627:therapeutic use; D005437:Flucytosine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007121:Immunocompetence; D019586:Intracranial Hypertension / Q000188:drug therapy; D007427:Intracranial Pressure / Q000187:drug effects; D017964:Itraconazole / Q000627:therapeutic use; D016919:Meningitis, Cryptococcal / Q000097:blood / Q000188:drug therapy*; D015337:Multicenter Studies as Topic; D010219:Papua New Guinea
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D004338:Drug Combinations; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine; D006854:Hydrocortisone