Sandbox fungal meningitis: Difference between revisions

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! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Preferred Regimen''
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Preferred Regimen''
|-
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| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal amphotericin B]] 5 mg/kg/day for 4–6 weeks'''''  
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal amphotericin B]] 5 mg/kg/day IV for 4–6 weeks'''''  
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| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''Followed  By''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''Followed  By''
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! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Preferred Regimen''
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Preferred Regimen''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[FLuconazole]] 400 mg/day PO'''''<BR>''OR''<BR>▸ '''''[[Itraconazole]] 400–600 mg/day'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[FLuconazole]] 400 mg/day PO'''''<BR>''OR''<BR>▸ '''''[[Itraconazole]] 400–600 mg/day PO'''''
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===Cryptococcus HIV/AIDS===<ref name="pmid24052889">Antinori S (2013) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24052889 New Insights into HIV/AIDS-Associated Cryptococcosis.] ''ISRN AIDS'' 2013 ():471363.http://dx.doi.org/10.1155/2013/471363 DOI:10.1155/2013/471363] PMID: [http://pubmed.gov/24052889 24052889]</ref>
===Cryptococcus HIV/AIDS<ref name="pmid24052889">Antinori S (2013) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24052889 New Insights into HIV/AIDS-Associated Cryptococcosis.] ''ISRN AIDS'' 2013 ():471363.http://dx.doi.org/10.1155/2013/471363 DOI:10.1155/2013/471363] PMID: [http://pubmed.gov/24052889 24052889]</ref>===


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! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Consolidation phase(for 8 wks)''
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Consolidation phase(for 8 wks)''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400 mg/day PO'''''<BR>''OR''<BR>▸ '''''[[Itraconazole]] 400 mg/day'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400 mg/day PO'''''<BR>''OR''<BR>▸ '''''[[Itraconazole]] 400 mg/day PO'''''
|-
|-
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Maintenance phase''
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Maintenance phase''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 200 mg/day'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 200 mg/day PO'''''
|-
|-
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===Cryptococcus Immunocompetent===<ref name="pmid22763808">Jackson A, van der Horst C (2012) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=22763808 New insights in the prevention, diagnosis, and treatment of cryptococcal meningitis.] ''Curr HIV/AIDS Rep'' 9 (3):267-77. [http://dx.doi.org/10.1007/s11904-012-0127-7 DOI:10.1007/s11904-012-0127-7] PMID: [http://pubmed.gov/22763808 22763808]</ref>
===Cryptococcus Immunocompetent<ref name="pmid22763808">Jackson A, van der Horst C (2012) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=22763808 New insights in the prevention, diagnosis, and treatment of cryptococcal meningitis.] ''Curr HIV/AIDS Rep'' 9 (3):267-77. [http://dx.doi.org/10.1007/s11904-012-0127-7 DOI:10.1007/s11904-012-0127-7] PMID: [http://pubmed.gov/22763808 22763808]</ref>===


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! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Consolidation phase(for 8 wks)''
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Consolidation phase(for 8 wks)''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400 mg/day PO'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400 mg/day PO qd'''''
|-
|-
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Maintenance phase(for 12 mo)''
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Maintenance phase(for 12 mo)''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 200 mg/day'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 200 mg PO qd'''''
|-
|-
|}
|}

Revision as of 17:40, 20 January 2014

Meningitis Main Page

Patient Information

Overview

Causes

Classification

Viral Meningitis
Bacterial Meningitis
Fungal Meningitis

Differential Diagnosis

Diagnosis

Treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;Sheng Shi, M.D. [2]


fungal meningitis

Blastomyces

Blastomyces
Preferred Regimen
▸ Liposomal amphotericin B 5 mg/kg/day IV for 4–6 weeks
Followed By
▸ Fluconazole 800 mg/day PO
OR
▸ Itraconazole 200 mg PO bid or tid
OR
▸ Voriconazole 200–400 mg IV q12h


Candidiasis

Candidiasis
Preferred Regimen
▸ lipid-based ampho B 3–5 mg/kg/day
PLUS OR NOT
▸ 5-Fluorocytosine 25 mg/kg PO qid
Alternative Regimen
▸ Fluconazole 400–800 mg (6–12 mg/kg) IV or PO


Histoplasma

Histoplasma
Preferred Regimen
▸ Liposomal ampho B 5 mg/kg/d, for a total of 175 mg/kg over 4-6 wk
Followed By
▸ Itraconazole 200 mg/day PO bid or tid for at least 12 month


Coccidioides

Coccidioides
Preferred Regimen
▸ FLuconazole 400 mg/day PO
OR
▸ Itraconazole 400–600 mg/day PO


Cryptococcus HIV/AIDS[1]

Cryptococcus, HIV/AIDS
Induction Phrase(for 2 wks)
▸ Amphotericin B deoxycholate 0.7 mg/kg/day IV
PLUS
▸ 5-Fluorocytosine 100 mg/kg/day PO
Consolidation phase(for 8 wks)
▸ Fluconazole 400 mg/day PO
OR
▸ Itraconazole 400 mg/day PO
Maintenance phase
▸ Fluconazole 200 mg/day PO


Cryptococcus Immunocompetent[2]

Cryptococcus, Immunocompetent
Induction Phrase(for 2 wks)
▸ Amphotericin B 0.7-1 mg/kg/day IV
OR
▸ Liposomal amphotericin B 5 mg/kg/day PO
PLUS
▸ 5-Fluorocytosine 25 mg/kg PO q6h
Consolidation phase(for 8 wks)
▸ Fluconazole 400 mg/day PO qd
Maintenance phase(for 12 mo)
▸ Fluconazole 200 mg PO qd



References

  1. ↑ Antinori S (2013) New Insights into HIV/AIDS-Associated Cryptococcosis. ISRN AIDS 2013 ():471363.http://dx.doi.org/10.1155/2013/471363 DOI:10.1155/2013/471363] PMID: 24052889
  2. ↑ Jackson A, van der Horst C (2012) New insights in the prevention, diagnosis, and treatment of cryptococcal meningitis. Curr HIV/AIDS Rep 9 (3):267-77. DOI:10.1007/s11904-012-0127-7 PMID: 22763808
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