Disease relevance of Meningitis, Cryptococcal

• In 36 patients with other infections, S-adenosylmethionine concentrations were much the same as in controls: 18 had bacterial pneumonia, two tuberculosis, five cryptococcal meningitis, three had other infections, and eight had asymptomatic HIV-1 infection [1].
• Fluconazole use was associated with a decreased relative rate of 0.49 (P = 0.06) for cryptococcal meningitis and a decreased relative rate of 0.61 (P = 0.005) for esophageal candidiasis [2].
• Progressive multifocal leukoencephalopathy and cryptococcal meningitis with systemic lupus erythematosus and thymoma [3].
• The patient was a 68-yr-old woman with hypo-gamma-globulinemia (IgM: 31 mg/dl, IgG: 223 mg/dl, IgA: 23 mg/dl); she suffered from cryptococcal meningitis and pulmonary tuberculosis with a negative result of skin tests to PPD and cryptococcal antigen [4].
• Toxicity of amphotericin B plus flucytosine in 194 patients with cryptococcal meningitis [5].

High impact information on Meningitis, Cryptococcal

• Fluconazole is useful in the common forms of fungal meningitis--namely, coccidioidal and cryptococcal meningitis [6].
• Fluconazole is an effective alternative to amphotericin B as primary treatment of cryptococcal meningitis in patients with AIDS [7].
• Among the 89 patients with cryptococcal meningitis confirmed by culture, survival did not differ significantly between those treated with amphotericin plus flucytosine (n = 49) and those treated with amphotericin alone (n = 40) [8].
• As a consequence, virulence of the gpa1 mutant strain was significantly attenuated in an animal model of cryptococcal meningitis [9].
• Failure of ketoconazole in cryptococcal meningitis [10].

Chemical compound and disease context of Meningitis, Cryptococcal

• Amphotericin versus fluconazole in cryptococcal meningitis [11].
• False negative latex agglutination test in cryptococcal meningitis [12].
• This paper describes the salient features of a new model for chronic cryptococcal meningitis in cortisone-treated rabbits [13].
• Treatment of cryptococcal meningitis was successful in 17 of the 19 patients given fluconazole but only three of the six receiving itraconazole [14].
• Successful treatment of cryptococcal meningitis with liposomal amphotericin B after failure of treatment with fluconazole and conventional amphotericin B [15].

Biological context of Meningitis, Cryptococcal

• OBJECTIVE: To study the effect of rifampicin on the pharmacokinetics of fluconazole and on clinical outcomes of fluconazole treatment in patients with AIDS-related cryptococcal meningitis [16].
• The case of an 18-year-old pregnant woman with cryptococcal meningitis treated with amphotericin B and flucytosine since the third trimester of pregnancy is reported [17].

Anatomical context of Meningitis, Cryptococcal

• Fluconazole penetrates the cerebrospinal fluid well and is approved for primary and suppressive therapy of cryptococcal meningitis in AIDS patients [18].
• Despite limited penetration into the subarachnoid space, at all three doses tested albaconazole was as effective as fluconazole for the treatment of cryptococcal meningitis in rabbits [19].
• In vitro experiments suggest that the low NK activity of cryptococcal meningitis patients is not due to amphotericin B therapy or blockade of NK cells by C. neoformans-derived molecules [20].

Gene context of Meningitis, Cryptococcal

• IFN-gamma at the site of infection determines rate of clearance of infection in cryptococcal meningitis [21].
• The ras1 mutant strain was also avirulent in an animal model of cryptococcal meningitis [22].
• A cryptococcal meningitis model in corticosteroid-treated rabbits was used to assess the requirement for the phosphoribosylaminoimidazole gene (ADE2) for virulence of Cryptococcus neoformans [23].
• The highest CSF concentrations of TNF-alpha (greater than 100 ng/l), however, were found in seven out of eight patients with cryptococcal meningitis [24].
• CONCLUSIONS: Refractory meningitis may be due to defective TNF and IFN- gamma production, and IFN- gamma treatment may be useful in patients with an impaired cellular immune response and refractory cryptococcal meningitis [25].

Analytical, diagnostic and therapeutic context of Meningitis, Cryptococcal

• A diagnosis of cryptococcal meningitis was made after lumbar puncture and treatment with intravenous amphotericin B and 5-fluorcytosine was begun [26].
• Data on patients with AIDS-associated cryptococcal meningitis from my laboratory demonstrated that the use of fluconazole MICs in conjunction with clinical variables, such as blood culture results, enhances the ability to predict treatment outcome [27].
• Although fluconazole appears to be as effective as amphotericin B, only a prospective multicenter study will determine the best treatment regimen for patients with cryptococcal meningitis who do not have AIDS [28].
• To evaluate the efficacy and safety of Amphotericin B dissolved in dextrose (Amb) or in a lipid emulsion (Intralipid, Amb-IL) in AIDS patients with cryptococcal meningitis, we conducted a retrospective study in 30 AIDS patients with cryptococcal meningitis [29].
• Miconazole was well tolerated, and would appear to be a relatively non-toxic and effective drug in the treatment of cryptococcal meningitis which is refractory to conventional chemotherapy [30].

References