Sandbox fungal meningitis: Difference between revisions

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|-! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Intensive Phase(for 9-12 mo)''
|-! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Intensive Phase(for 9-12 mo)''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampicin]] 8-12 mg/kg/day PO max: 600mg'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampicin]] 8-12 mg/kg/day PO daily max: 600mg<BR> ''OR''<BR> 8-12mg/kg/day PO 3 times per week x:600mg'''''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Isoniazid]] 4-6 mg/kg/day PO max: 300mg'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Isoniazid]] 4-6 mg/kg/day PO daily max: 300mg<BR>''OR''<BR> 8-12mg/kg/day PO 3 times per week daily max:900mg'''''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Pyrazinamide]] 20-30 mg/kg/day PO'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Pyrazinamide]] 20-30 mg/kg/day PO<BR>''OR''<BR> 30-40mg/kg/day PO 3 times per week'''''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Streptomycin]] 12-18 mg/kg/day PO'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Streptomycin]] 12-18 mg/kg/day IM<BR>''OR''<BR> 25-35mg/kg/day PO 3 times per week daily max:1000mg'''''
|-
|-
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Continuation Phase''
! style="padding: 0 5px; font-size: 80%; background: #F5F5F5" align=left | ''Continuation Phase''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampicin]] 8-12 mg/kg/day PO max: 600mg'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampicin]] 8-12 mg/kg/day PO daily max: 600mg<BR>''OR''<BR> 8-12mg/kg/day PO 3 times per week daily max:600mg'''''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ''PLUS''
|-
|-
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Isoniazid]] 4-6 mg/kg/day PO max: 300mg'''''
| style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Isoniazid]] 4-6 mg/kg/day PO daily max: 300mg<BR>''OR''<BR> 8-12mg/kg/day PO 3 times per week daily max:900mg'''''
|-
|-
|}
|}
|}
|}
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 19:55, 22 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[1]

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


Cryptococcus HIV/AIDS[2]

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[3]

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



Viral Meningitis[4]

Herpes simplex Meningitis
Preferred Regimen
▸ Aciclovir IV
OR
▸ Valaciclovir PO


Parasitic Meningitis

Angiostrongyliasis

Angiostrongyliasis
Preferred Regimen
▸ albendazole


M. tuberculosis Meningitis

M. tuberculosis
▸ Rifampicin 8-12 mg/kg/day PO daily max: 600mg
OR
8-12mg/kg/day PO 3 times per week x:600mg
PLUS
▸ Isoniazid 4-6 mg/kg/day PO daily max: 300mg
OR
8-12mg/kg/day PO 3 times per week daily max:900mg
PLUS
▸ Pyrazinamide 20-30 mg/kg/day PO
OR
30-40mg/kg/day PO 3 times per week
PLUS
▸ Streptomycin 12-18 mg/kg/day IM
OR
25-35mg/kg/day PO 3 times per week daily max:1000mg
Continuation Phase
▸ Rifampicin 8-12 mg/kg/day PO daily max: 600mg
OR
8-12mg/kg/day PO 3 times per week daily max:600mg
PLUS
▸ Isoniazid 4-6 mg/kg/day PO daily max: 300mg
OR
8-12mg/kg/day PO 3 times per week daily max:900mg

References

  1. ↑ Galgiani JN, Ampel NM, Blair JE, Catanzaro A, Johnson RH, Stevens DA et al. (2005) Coccidioidomycosis. Clin Infect Dis 41 (9):1217-23. DOI:10.1086/496991 PMID: 16206093
  2. ↑ 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
  3. ↑ 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
  4. ↑ Studahl M, Lindquist L, Eriksson BM, Günther G, Bengner M, Franzen-Röhl E et al. (2013) Acute viral infections of the central nervous system in immunocompetent adults: diagnosis and management. Drugs 73 (2):131-58. DOI:10.1007/s40265-013-0007-5 PMID: 23377760
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