Fluconazole Therapy for 5 cases of Cryptococcal Meningitis

Abstract

Cryptococcal meningitis is a relatively common central nervous system infection by Cryptococcus neoformans. Before the introduction of amphotericin B in 1956, cryptococcal infection of the central nervous system had been almost uniformly fatal. Although amphotericin B(alone or in combination with flucytosine) has been the standard therapeutic regimen, problems such as modest efficacy, nephrotoxcity, other clinically significant toxicities, and the inconvinience of intravenous dosing have led to search for a new antimycotic agents. Fluconazole is a new therapeutic agent which is effective as amphoterin B. Accumulating evidence suggests that the antifungal triazole fluconazole represent an advance in the treatment of cryptococcal meningitis, particulary in acquired immunodeficiency syndrom patients. Thus we report clinical experiences of fluconazole therapy for 5 cases of cryptococcal meningitis. Four of 5 patients are improved clinically and microbiologically, 1 of 5 patients is expired due to concomittent tuberculous infection.