title: Simultaneous cryptococcal and tuberculous meningitis in a patient with systemic lupus erythematosus.
abstract: Simultaneous central nervous system (CNS) infection with Cryptococcus and tuberculosis (TB) is very rare. Despite improved therapeutic options, treatment of CNS cryptococcosis is still difficult and needs invasive treatment modalities, such as intrathecal or intraventricular amphotericin B, in refractory cases. We describe a patient with systemic lupus erythematosus diagnosed with simultaneous cryptococcal and TB meningitis who had a poor response to intravenous liposomal amphotericin B and fluconazole, but was successfully treated with intraventricular amphotericin B, in addition to anti-TB therapy.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. Electronic address: bigimete@yahoo.com.
authors.forename: Bilgul
authors.initials: B
authors.lastname: Mete
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Nese
authors.initials: N
authors.lastname: Saltoglu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Vanli
authors.affiliation: Department of Neurology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Ozkara
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Arslan
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Mert
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Resat
authors.initials: R
authors.lastname: Ozaras
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Fehmi
authors.initials: F
authors.lastname: Tabak
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Ozturk
mesh_terms: D061605:Administration, Intravenous; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D000995:Antitubercular Agents / Q000008:administration & dosage; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage; D006801:Humans; D057967:Infusions, Intraventricular; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D016919:Meningitis, Cryptococcal / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D000935:Antifungal Agents; D000995:Antitubercular Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole
keywords: Cryptococcus; Intraventricular amphotericin B; Meningitis; Tuberculosis