Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune: reporte de un caso / Cerebral cryptococcosis and immune reconstitution inflammatory syndrome: case report
Rev. méd. Chile
;
146(12): 1481-1485, dic. 2018. graf
Article
in Spanish
| LILACS
| ID: biblio-991360
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:
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Index:
LILACS (Americas)
Main subject:
Amphotericin B
/
Meningitis, Cryptococcal
/
AIDS-Related Opportunistic Infections
/
Deoxycholic Acid
/
Immune Reconstitution Inflammatory Syndrome
/
Voriconazole
/
Antifungal Agents
Limits:
Humans
/
Male
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2018
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Hospital Base de Valdivia/CL
/
Universidad Austral de Chile/CL
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