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.
University of Washington Biobehavioral Nursing and Health Systems, Box 357266, Seattle, WA 98195-7266, USA. hilairet@u.washington.edu
Hilaire J
HJ
Thompson
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