The role of an Ommaya reservoir in the management of children with cryptococcal meningitis.
Cryptococcal meningitis is the most common life-threatening fungal infection and is associated with high mortality in children. Amphotericin B plus flucytosine and fluconazole is the optimal current therapy. Implantation of an Ommaya reservoir for intraventricular infusion of medication and aspiration of cerebrospinal fluid (CSF) for the treatment of increased intracranial pressure (ICP) has been reported. Intraventricular injection of amphotericin B through an Ommaya reservoir in children with cryptococcal meningitis has not been reported previously. We report two children who had cryptococcal meningitis and associated increased intracranial pressure, and were treated with an Ommaya reservoir. Both patients experienced rapid reversal of symptoms. At the time of discharge both patients had recovered and have remained asymptomatic.
Jiang
Pei-Fang
PF
Department of Neurology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Yu
Hui-Min
HM
Zhou
Bo-Lin
BL
Gao
Feng
F
Shen
Si-Xiang
SX
Xia
Zhe-Zhi
ZZ
Shui
Quan-Xiang
QX
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002648:Child; D003455:Cryptococcus neoformans; D016503:Drug Delivery Systems; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology* / Q000628:therapy; D008297:Male; D016919:Meningitis, Cryptococcal / Q000150:complications / Q000188:drug therapy*
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine