Nursing Management of Lumbar Drainage in Cryptococcal Meningitis: A Case Report.

Raised intracranial pressure is a hallmark of cryptococcal meningitis and is associated with increased mortality. Continuous drainage of lumbar cerebrospinal fluid is suggested to control intracranial pressure. The complications induced by this treatment have been described. However, nursing care associated with identification and management of complications is less well known. We encountered a patient with human immunodeficiency virus-negative cryptococcal meningitis who developed increasing cerebrospinal fluid pressure, hearing impairment, and limb weakness. The patient's symptoms improved significantly by antifungal therapy and continuous lumbar drainage. Nurses play a vital role in monitoring patients with lumbar drainage for complications and to maintain integrity of the system. The nursing role in this approach is discussed with particular emphasis on recognition of complications and responses toward immediate emergent intervention.

Neurological complications associated with HIV and AIDS: clinical implications for nursing.

This article provides a clinical nursing update on major neurological complications associated with HIV and AIDS. Life expectancy for those with AIDS has increased as a consequence of antiretroviral therapy, and thus, neurological complications remain a clinical challenge. Four significant diseases associated with HIV and AIDS are addressed: HIV-associated dementia, peripheral neuropathy, cryptococcal meningitis, and toxoplasmosis. Updated statistics, a review of pathophysiology, common manifestations, diagnostic tests, and standard treatments are discussed for each disease. Nursing considerations when caring for this population are reviewed and include assessment, safety, activities of daily living, pain management, and treatment adherence.

Meningitis Criptocococica experiencia del Departamento de Medicina Interna del Hospital Japones / Meningitis Criptocococica experience of department of medicine interne and Hospital Japones

Se analizaron 6 casos de criptocococisis meningea, registrado entre 1987 y 1993. El diagnostico se efectuo por el hallazgo de criptococos neoformans en LCR, mediante el examen de tinta china. Es estudio citoquimico del LCR, evidencio un liquido claro, con pleocitosis, a predominio de polimorfo nucleares, hiperproteinorraquia y agluco o hipoglucorraquia. Los signos y sintomas mas comunes fueron cefalea, cambios en la conducta y rigidez de nuca. Dos de nuestros pacientes recibieron tratamiento con Anfotericina B, a dosis convencionales, con excelente resultado, dos fallecieron, unos de ellos tenia SIDA, dos solicitaron alta medica, en tres casos se detecto hidrocefalia como complicacion de la enfermedad

Cryptococcal meningitis in patients with AIDS.

In the U.S., cryptococcal meningitis is the most common form of fungal meningitis and a major cause of morbidity and mortality among immuno-suppressed patients. In the AIDS patient, cryptococcal meningitis often presents with fever and headache and is best treated with intravenous amphotericin B and oral flucytosine, or fluconazole. However, toxic effects may result from the therapy. This disease frequently relapses necessitating life-long treatment to prevent reactivation. Essential management principles focusing upon health education are presented to promote comprehensive nursing care for patients testing positive for the human immunodeficiency virus who also have cryptococcal meningitis.