[Cerebral cryptococcosis and immune reconstitution inflammatory syndrome. Case report]. / Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso.
Rev Med Chil
; 146(12): 1481-1485, 2018 Dec.
Article
in Es
| MEDLINE
| ID: mdl-30848753
ABSTRACT
We report a 45-year-old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycholate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma levels of voriconazole were insufficient with a standard dose (0.7 µg/mL), therefore, the dose was increased thereafter to reach appropriate levels (4.5 µg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Amphotericin B
/
Meningitis, Cryptococcal
/
AIDS-Related Opportunistic Infections
/
Deoxycholic Acid
/
Immune Reconstitution Inflammatory Syndrome
/
Voriconazole
/
Antifungal Agents
Limits:
Humans
/
Male
/
Middle aged
Language:
Es
Journal:
Rev Med Chil
Year:
2018
Type:
Article
Affiliation country:
Chile