Use of cerebrospinal fluid shunt for the management of elevated intracranial pressure in a patient with active AIDS-related cryptococcal meningitis.
Persistently elevated intracranial pressure (ICP) is one of the most accurate predictors of a poor prognosis in patients with AIDS-related cryptococcal meningitis. We present a severe case of persistent cryptococcal meningitis in a patient with advanced AIDS, complicated by elevation of ICP. A ventriculoperitoneal shunt was placed that successfully lowered the ICP and alleviated the associated symptoms. The elevated ICP secondary to AIDS-related cryptococcal meningitis should be treated aggressively. Despite the risk of shunt complications, cerebrospinal fluid shunts can be considered in these patients if they do not respond to other treatment.
Mylonakis
E
E
Department of Medicine, Miriam Hospital, Brown University School of Medicine, Providence, RI 02906, USA.
Merriman
N A
NA
Rich
J D
JD
Flanigan
T P
TP
Walters
B C
BC
Tashima
K T
KT
Mileno
M D
MD
van der Horst
C M
CM
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D016919:Meningitis, Cryptococcal / Q000503:physiopathology / Q000628:therapy*; D017287:Ventriculoperitoneal Shunt