RESUMEN
Patients with coccidioidal meningitis require lifelong antifungal therapy. Cumulative toxicity and lack of antifungal efficacy require salvage therapy in the treatment of some patients. In a retrospective review of nine patients with coccidioidal meningitis treated with isavuconazole, successful therapy was seen in three patients and stable disease was confirmed in six patients. Isavuconazole may be a useful addition to the therapeutic choices currently available for coccidioidal meningitis.
Asunto(s)
Antifúngicos/uso terapéutico , Coccidioidomicosis/tratamiento farmacológico , Meningitis Fúngica/tratamiento farmacológico , Nitrilos/uso terapéutico , Piridinas/uso terapéutico , Triazoles/uso terapéutico , Adulto , Antifúngicos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nitrilos/efectos adversos , Piridinas/efectos adversos , Estudios Retrospectivos , Resultado del Tratamiento , Triazoles/efectos adversosRESUMEN
Culture-negative endocarditis has long been associated with systemic lupus erythematosus, but is usually asymptomatic or involves a single valve. We present a patient with destructive culture-negative endocarditis that remains without a microbial etiology despite an exhaustive workup using advanced diagnostic techniques in a patient with systemic lupus erythematosus.