Not your "typical patient": cryptococcal meningitis in an immunocompetent patient.
Meningitis, when caused by the fungal mycoses Cryptococcus neoformans, is normally seen in immuno-compromised hosts. However, immunocompetent patients are also susceptible to cryptococcal meningitis (CM). In patients with an intact immune system, CM usually presents with the typical signs and symptoms of meningitis: fever, stiff neck, and headache. Major implications for the primary and advanced practice nursing plans of care for CM patients include a thorough history and physical exam, early diagnosis and treatment, and an individualized plan of care focused on minimizing sequelae and side effects of treatment and maximizing functional recovery.
Thompson
Hilaire J
HJ
University of Washington Biobehavioral Nursing and Health Systems, Box 357266, Seattle, WA 98195-7266, USA. hilairet@u.washington.edu
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D003244:Consciousness Disorders / Q000382:microbiology; D005221:Fatigue / Q000382:microbiology; D005437:Flucytosine / Q000627:therapeutic use; D018023:HIV Seronegativity; D006261:Headache / Q000382:microbiology; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008487:Medical History Taking; D016919:Meningitis, Cryptococcal / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D008875:Middle Aged; D009325:Nausea / Q000382:microbiology; D024802:Nurse's Role; D009730:Nursing Assessment; D010347:Patient Care Planning; D010808:Physical Examination; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt
D000935:Antifungal Agents; D000666:Amphotericin B; D005437:Flucytosine