隐球菌性脑膜炎抗真菌治疗演示文稿.pptVIP

Retrospective study in non-AIDS patients 306 non-HIV-infected patiens with cryptococcosis, among whom 157 patients had CNS disease 90% of patients receiving an AmB-containing regimen as initial therpay The median duration of therapy with AmB was 27 days in this population, and about two thirds also received 5-FC for a median time of 31 days The total amount of AmB given as antifungal therapy was approximately 800 mg, and the total daily dose of 5-FC was approximately 100 mg/kg Fluconazole was given as initial therapy at doses of 400 to 800 mg in only a few patients Fluconazole was given in two thirds of patients following a successful induction regimen containing AmB These patients received fluconazole at a median dose of 400 mg for a median duration of 10 weeks Other initial regimens were uncommon and could not be adequately assessed Pappas et al. Clin Infect Dis. 2001. 33: 690 AmB lipid formulations Liposomal AmB the same effective as AmB Less toxic than AmB CSF culture conversion significantly earlier than did patients given AmB --Leenders et al. AIDS. 1997. 11: 1463 --Hamill et al. 1999. 39th ICAAC, San Francisco, Abstract 1161 Antifungal Treatment for Cryptococcal Meningitis Li-Ping Zhu, Xin-Hua Weng Huashan Hospital, Fudan University Shanghai China Challenge for Cryptococcal Meningitis Cryptococcus neoformans is the most common cause of fungal meningitis in HIV and non-HIV-infected patients Found in 7%-10% patients with AIDS Remain high mortality rate (10%-44%), especially in immunocompromised patients Case Study Present History A 46-year-old man was admitted to our hospital because of fevers and headache for over 2 months Lumbar puncture showed a WBC count of 58×106/L with 0.94 monocytes, protein was