A new method for the treatment of chronic fungal meningitis: continuous infusion into the cerebrospinal fluid for coccidioidal meningitis.
Coccidioidal meningitis is a lethal disease, and current therapy is not curative or is burdened with serious toxicities and logistic difficulties. In a patient with refractory disease, continuous infusion amphotericin B therapy was given via a programmable implanted pump into the cisternal subarachnoid space. The patient progressively responded, evidenced clinically and by laboratory studies. Drug delivery issues were addressed during this course that could guide future use of this modality, which is a promising novel avenue of therapy for chronic meningitis.
Berry
Carol D
CD
Department of Medicine, Kaiser Permanente South Sacramento Medical Center, Sacramento, California, USA.
Stevens
David A
DA
Hassid
Eric I
EI
Pappagianis
Demosthenes
D
Happs
Edie L
EL
Sahrakar
Kamran
K
D000666:Amphotericin B / Q000008:administration & dosage / Q000134:cerebrospinal fluid / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000134:cerebrospinal fluid / Q000627:therapeutic use; D003047:Coccidioidomycosis / Q000134:cerebrospinal fluid / Q000188:drug therapy; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D016921:Meningitis, Fungal / Q000134:cerebrospinal fluid / Q000188:drug therapy; D055815:Young Adult
D000935:Antifungal Agents; D000666:Amphotericin B