Template:ID-Fungal meningitis
- Fungal meningitis
- Blastomyces dermatitidis[1]
- Preferred regimen: Liposomal Amphotericin B 5 mg/kg/day IV for 4–6 weeks, followed by Fluconazole 800 mg PO qd OR Itraconazole 200 mg PO bid–tid OR Voriconazole 200–400 mg PO bid for ≥12 months until CSF abnl resolves
- Candida spp.[2]
- Preferred regimen: Liposomal Amphotericin B 3–5 mg/kg/day IV ± Flucytosine 25 mg/kg PO qid for several weeks, followed by Fluconazole 400–800 mg (6–12 mg/kg) PO qd until CSF abnl resolves
- Alternative regimen: Fluconazole 400–800 mg PO qd (6–12 mg/kg IV q24h) OR Voriconazole 400 mg PO bid for 2 doses, followed by 200 mg PO bid OR Voriconazole 6 mg/kg IV q12h for 2 doses, followed by 3 mg/kg IV q12h
- Note: Removal of intraventricular devices is recommended.
- Coccidioides immitis[3]
- Preferred regimen: Fluconazole 400 mg PO qd
- Alternative regimen: Itraconazole 200 mg PO bid–tid
- Cryptococcus neoformans[4]
- Non–HIV/AIDS hosts, non–transplant recipients
- Induction therapy: (Amphotericin B 0.7–1.0 mg/kg IV q24h for 4–6 weeks OR Liposomal Amphotericin B 3–4 mg/kg IV q24h for 4–6 weeks OR Amphotericin B lipid complex 5 mg/kg IV q24h for 4–6 weeks) AND Flucytosine 25 mg/kg PO q6h for 4–6 weeks
- Consolidation therapy: Fluconazole 400–800 mg PO q24h for 8 weeks
- Maintenance therapy: Fluconazole 200 mg PO q24h for 6–12 months
- HIV/AIDS hosts
- Induction therapy (1): (Amphotericin B 0.7–1.0 mg/kg IV q24h for ≥ 2 weeks OR Liposomal Amphotericin B 3–4 mg/kg IV q24h for ≥ 2 weeks OR Amphotericin B lipid complex 5 mg/kg IV q24h for ≥ 2 weeks) AND Flucytosine 25 mg/kg PO q6h for ≥ 2 weeks
- Induction therapy (2): Amphotericin B 0.7–1.0 mg/kg IV q24h for 4–6 weeks OR Liposomal Amphotericin B 3–4 mg/kg IV q24h for 4–6 weeks OR Amphotericin B lipid complex 5 mg/kg IV q24h for 4–6 weeks
- Induction therapy (3): Amphotericin B 0.7–1.0 mg/kg IV q24h for 2 weeks AND Fluconazole 800 mg PO q24h for 2 weeks
- Induction therapy (4): Fluconazole 1200 mg PO q24h for 6 weeks AND Flucytosine 100 mg/kg PO q24h for 6 weeks
- Induction therapy (5): Fluconazole 800–2000 mg PO q24h for 10–12 weeks
- Induction therapy (6): Itraconazole 200 mg PO q12h for 10–12 weeks
- Consolidation therapy: Fluconazole 400 mg PO q24h for 8 weeks
- Maintenance therapy: Fluconazole 200 mg PO q24h for ≥ 1 year OR Itraconazole 400 mg PO q24h for ≥ 1 year OR Amphotericin B 1.0 mg/kg/week IV for ≥ 1 year
- Transplant recipients
- Induction therapy (1): (Liposomal Amphotericin B 3–4 mg/kg IV q24h for ≥ 2 weeks OR Amphotericin B lipid complex 5 mg/kg IV q24h for ≥ 2 weeks) AND Flucytosine 25 mg/kg PO q6h for ≥ 2 weeks
- Induction therapy (2): Liposomal Amphotericin B 3–4 mg/kg IV q24h for 4–6 weeks OR Amphotericin B lipid complex 5 mg/kg IV q24h for 4–6 weeks
- Consolidation therapy: Fluconazole 400–800 mg PO q24h for 8 weeks
- Maintenance therapy: Fluconazole 200–400 mg PO q24h for 6–12 months
- Histoplasma capsulatum
Preferred Regimen ▸ Liposomal Amphotericin B 5 mg/kg IV q24h for 4–6 weeks FOLLOWED BY ▸ Itraconazole 200 mg PO bid–tid for ≥12 months Adapted from Clin Infect Dis. 2007;45(7):807-25.[11]
- ↑ Chapman, Stanley W.; Dismukes, William E.; Proia, Laurie A.; Bradsher, Robert W.; Pappas, Peter G.; Threlkeld, Michael G.; Kauffman, Carol A.; Infectious Diseases Society of America (2008-06-15). "Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 46 (12): 1801–1812. doi:10.1086/588300. ISSN 1537-6591. PMID 18462107.
- ↑ Pappas, Peter G.; Kauffman, Carol A.; Andes, David; Benjamin, Daniel K.; Calandra, Thierry F.; Edwards, John E.; Filler, Scott G.; Fisher, John F.; Kullberg, Bart-Jan; Ostrosky-Zeichner, Luis; Reboli, Annette C.; Rex, John H.; Walsh, Thomas J.; Sobel, Jack D.; Infectious Diseases Society of America (2009-03-01). "Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 48 (5): 503–535. doi:10.1086/596757. ISSN 1537-6591. PMID 19191635.
- ↑ Galgiani, John N.; Ampel, Neil M.; Blair, Janis E.; Catanzaro, Antonino; Johnson, Royce H.; Stevens, David A.; Williams, Paul L.; Infectious Diseases Society of America (2005-11-01). "Coccidioidomycosis". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 41 (9): 1217–1223. doi:10.1086/496991. ISSN 1537-6591. PMID 16206093.
- ↑ Perfect, John R.; Dismukes, William E.; Dromer, Francoise; Goldman, David L.; Graybill, John R.; Hamill, Richard J.; Harrison, Thomas S.; Larsen, Robert A.; Lortholary, Olivier; Nguyen, Minh-Hong; Pappas, Peter G.; Powderly, William G.; Singh, Nina; Sobel, Jack D.; Sorrell, Tania C. (2010-02-01). "Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 50 (3): 291–322. doi:10.1086/649858. ISSN 1537-6591. PMID 20047480.