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Article in English | MEDLINE | ID: mdl-31685474

ABSTRACT

Miltefosine is an alkylphosphocholine compound that is used primarily for treatment of leishmaniasis and demonstrates in vitro and in vivo antiamebic activity against Acanthamoeba species. Recommendations for treatment of amebic encephalitis generally include miltefosine therapy. Data indicate that treatment with an amebicidal concentration of at least 16 µg/ml of miltefosine is required for most Acanthamoeba species. Although there is a high level of mortality associated with amebic encephalitis, a paucity of data regarding miltefosine levels in plasma and cerebrospinal fluid in vivo exists in the literature. We found that despite aggressive dosing (oral miltefosine 50 mg every 6 h) and therapeutic plasma levels, the miltefosine concentration in cerebrospinal fluid was negligible in a patient with AIDS and Acanthamoeba encephalitis.


Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Amebiasis/drug therapy , Amebicides/blood , Amebicides/cerebrospinal fluid , Central Nervous System Protozoal Infections/drug therapy , Infectious Encephalitis/drug therapy , Phosphorylcholine/analogs & derivatives , AIDS-Related Opportunistic Infections/blood , AIDS-Related Opportunistic Infections/cerebrospinal fluid , Acanthamoeba/drug effects , Acanthamoeba/isolation & purification , Adult , Amebiasis/blood , Amebiasis/cerebrospinal fluid , Amebicides/administration & dosage , Brain/parasitology , Central Nervous System Protozoal Infections/blood , Central Nervous System Protozoal Infections/cerebrospinal fluid , Humans , Infectious Encephalitis/blood , Infectious Encephalitis/cerebrospinal fluid , Male , Phosphorylcholine/administration & dosage , Phosphorylcholine/blood , Phosphorylcholine/cerebrospinal fluid
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