title: Ventriculoperitoneal shunts for treating increased intracranial pressure in cryptococcal meningitis with or without ventriculomegaly.
abstract: BACKGROUND
  Cryptococcosis is an opportunistic mycosis, especially in patients that are human immunodeficiency virus (HIV)-positive, and frequently involves the central nervous system.
  
  
  METHODS
  We assessed the potential of ventriculoperitoneal shunting (VPS) in preventing mortality due to uncontrollable intracranial hypertension (ICH) in 15 patients with acquired immunodeficiency syndrome (AIDS)-related cryptococcal meningitis.
  
  
  RESULTS
  After 2 weeks of antifungal therapy consisting of amphotericin B deoxycholate with or without fluconazole, patients with persistent ICH underwent VPS, despite having persistent Cryptococcus neoformans infection. In 12 patients, the uncontrollable ICH was resolved by VPS.
  
  
  CONCLUSIONS
  Patients with cryptococcal meningoencephalitis who have ICH must be considered for VPS even with positive cerebrospinal fluid cultures.
authors.affiliation: School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Corti
authors.affiliation: School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Maria
authors.initials: M
authors.lastname: Priarone
authors.affiliation: Mycology Unit, Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Negroni
authors.affiliation: Sociedad Iberoamericana de Información Cientifica, Buenos Aires, Argentina.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Gilardi
authors.affiliation: School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Jimena
authors.initials: J
authors.lastname: Castrelo
authors.affiliation: Mycology Unit, Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
authors.forename: Alicia Irene
authors.initials: AI
authors.lastname: Arechayala
authors.affiliation: Mycology Unit, Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Messina
authors.affiliation: Neurosurgery Department, Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Franze
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000382:microbiology / Q000601:surgery*; D008297:Male; D016919:Meningitis, Cryptococcal / Q000150:complications*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt; D055815:Young Adult