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Abstracts
Author(s) -
Moser Robert Harlan
Publication year - 1964
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt196456part1753
Subject(s) - medicine , creatinine , blood urea nitrogen , asymptomatic , coccidioides immitis , renal function , amphotericin b , cerebrospinal fluid , urine , meningitis , gastroenterology , surgery , antifungal , dermatology
A 22‐year‐old white man was admitted for evaluation of renal failure. Approximately 4 years before, after a diagnosis of primary pulmonary coccidiomycosis had been established, he was given amphotericin B, 2.5 Gm. in 36 divided doses intravenously, which resulted in clinical improvement, but with elevation of blood urea nitrogen from 5 mg. per 100 ml. to 28 mg. per 100 ml. Three months later the subject was admitted for headache, stiff neck, and fever. Complement fixing antibodies to Coccidioides immitis were identified in the cerebrospinal fluid. He was given amphotericin B, 9.2 Gm. intravenously and 49 mg. intrathecally, over a 6 month period. The patient was completely asymptomatic but had a persistent complement‐fixing antibody. Blood urea nitrogen, which had been 8 mg. per 100 ml. at the onset of the second course, rose to 47 mg. per 100 ml. Serum creatinine was 2.2 mg. per 100 ml. During a period of 5 months, spinal fluid remained clear, blood urea nitrogen fell to 22 mg. per 100 ml., and creatinine descended to 1.8 mg. per 100 ml.