What new treatments for cryptococcal meningitis are needed?Įffective treatments exist to drastically reduce deaths from cryptococcal meningitis, but they are often not used because of cost, lack of availability, and other access issues. While some projects are providing flucytosine in a few selected countries, most patients do not have access to this critical drug for the treatment of cryptococcal meningitis. Flucytosine is only registered in a few African countries. For certain patients the tablets are crushed and delivered through a nasogastric tube. Flucytosine must be taken 4 times per day. In practice, however, treatment is often just fluconazole, which is ineffective.Īmphotericin B can be toxic to the kidneys and is delivered intravenously, making it impractical to administer in many settings. followed by, finally, fluconazole at 200 mg/day for at least a yearĭepending on drug availability, the initial two weeks of treatment may be replaced by either two weeks of 1200 mg/day fluconazole and 100 mg/kg/day flucytosine divided into four doses per day, or two weeks of 1 mg/kg/day amphotericin B deoxycholate and 1200 mg/day fluconazole.followed by fluconazole at 800 mg/day for eight weeks.followed by fluconazole at 1200 mg/day for one week.1 mg/kg/day amphotericin B and 100 mg/kg/day flucytosine divided into four doses per day for one week.The World Health Organization recommends that cryptococcal meningitis is treated with: What are current treatments for cryptococcal meningitis? Cryptococcal meningitis is far less common among children with advanced HIV disease. Adhering to antiretroviral therapy for many years also brings challenges. If left untreated, cryptococcal meningitis usually leads to more serious symptoms and ultimately death.Īntiretroviral therapy helps improve the immune systems of HIV patients, reducing the risk of cryptococcal meningitis, but the infection remains a serious problem in areas where HIV is very common. Symptoms include fever, headache, stiff neck, nausea and vomiting, increased sensitivity to light, and confusion. ![]() If breathed in, the spores can multiply and spread from the lungs to the membranes that cover the brain or spinal cord, causing meningitis.Ĭryptococcal meningitis is rare in healthy people, but it is a major cause of illness and death in people with advanced HIV disease, whose impaired immune system makes them more likely to get this infection. Cryptococcal meningitis is a fungal infection caused by Cryptococcus neoformans, which is often found in bird droppings.
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