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Fallbericht. Wiederanstieg des Intrakranialdrucks bei antiretriviraler Therapie an einem AIDS‐Patienten mit Cryptococcus ‐Meningitis
Author(s) -
Cinti S. K.,
Armstrong Wendy S.,
Kauffman Carol A.
Publication year - 2001
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1046/j.1439-0507.2001.00663.x
Subject(s) - cryptococcal meningitis , medicine , cryptococcosis , antiretroviral therapy , intracranial pressure , raised intracranial pressure , meningitis , human immunodeficiency virus (hiv) , surgery , virology , immunology , viral disease , viral load
Summary. We present the case of an AIDS patient with cryptococcal meningitis who, after an excellent clinical and mycological response to antifungal therapy, developed an exacerbation of signs and symptoms, including elevated intracranial pressure and an increase in cerebrospinal fluid cryptococcal antigen and white blood cells, following the initiation of highly active antiretroviral therapy (HAART). Cultures yielded no growth and the patient responded to repeated lumbar punctures without changing or intensifying antifungal therapy. To our knowledge, this is the first report of symptomatic elevated intracranial pressure occurring during HAART‐related immune recovery in a patient with cryptococcal meningitis. Exacerbation of symptoms does not necessarily reflect mycological failure that requires a change in antifungal therapy, but may relate to acutely increased intracranial pressure that will respond to simple measures, such as repeated lumbar punctures.