Steroid responsive late deterioration in Cryptococcus neoformans variety gattii meningitis.
The authors describe the clinical course of Cryptococcus neoformans variety gattii infection in a young immunocompetent man who had a late deterioration characterized by headaches, subarachnoid inflammation, hydrocephalus, and stroke that reproducibly responded to steroids. These findings, in combination with declining markers of CSF infection, are consistent with the late deterioration being caused by sterile arachnoiditis rather than ongoing infection.
Department of Infectious Diseases, Cairns Base Hospital, and School of Medicine, James Cook University, Queensland, Australia.
Margaret
M
Lane
John
J
McBride
John
J
Archer
D000086:Acetazolamide / Q000627:therapeutic use; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001100:Arachnoiditis / Q000188:drug therapy / Q000209:etiology; D002544:Cerebral Infarction / Q000209:etiology; D003907:Dexamethasone / Q000627:therapeutic use*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000627:therapeutic use; D005437:Flucytosine / Q000627:therapeutic use; D006261:Headache / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D007121:Immunocompetence; D008297:Male; D016919:Meningitis, Cryptococcal / Q000134:cerebrospinal fluid / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011241:Prednisone / Q000627:therapeutic use*; D017287:Ventriculoperitoneal Shunt
D000935:Antifungal Agents; D003907:Dexamethasone; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine; D000086:Acetazolamide; D011241:Prednisone