Sandbox fungal meningitis

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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 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

===Cryptococcus HIV/AIDS===

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 Maintenance phase ▸ Fluconazole 200 mg/day

===Cryptococcus Immunocompetent===

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 Maintenance phase(for 12 mo) ▸ Fluconazole 200 mg/day