Persistent Cryptococcus neoformans infection of the prostate after successful treatment of meningitis. California Collaborative Treatment Group.
Study Objective: To assess the frequency of persistent Cryptococcus neoformans infection in patients with the acquired immunodeficiency syndrome (AIDS) after receiving apparently adequate treatment for meningitis.Design: Blood, urine, and cerebrospinal fluid were cultured at the conclusion of primar...
| Publicado en: | Annals of Internal Medicine Vol. 111; no. 2; pp. 125 - 129 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
American College of Physicians
7/15/89
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=6949354&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 6949354 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00034819 AIM jtl: Annals of Internal Medicine issn: 00034819 maglogo: N pubinfo: dt: 7/15/89 vid: 111 iid: 2 pid: 1652 pub: American College of Physicians place: Philadelphia, Pennsylvania artinfo: ui: 6949354 6949354 NLM2545124 6949354 10.7326/0003-4819-111-2-125 NLM2545124 6949354 ppf: 125 ppct: 4 formats: tig: atl: Persistent Cryptococcus neoformans infection of the prostate after successful treatment of meningitis. California Collaborative Treatment Group. aug: au: Larsen, Robert A. Bozzette, Samuel McCutchan, J. Allen Chiu, Joseph Leal, Mary Ann Richman, Douglas D. Larsen, R A Bozzette, S McCutchan, J A Chiu, J Leal, M A Richman, D D affil: Los Angeles County-University of Southern California Medical Center sug: subj: Meningitis Complications Cryptococcosis Etiology Prostatic Diseases Microbiology Amphotericin B Therapeutic Use Cryptococcus Cryptococcosis Drug Therapy Male Urine Microbiology Fluconazole Acquired Immunodeficiency Syndrome Complications Meningitis Etiology Antifungal Agents Therapeutic Use Drug Therapy, Combination Recurrence Heterocyclic Compounds Therapeutic Use Human Meningitis Drug Therapy Validation Studies Comparative Studies Evaluation Research Multicenter Studies Clinical Assessment Tools Male ab: Study Objective: To assess the frequency of persistent Cryptococcus neoformans infection in patients with the acquired immunodeficiency syndrome (AIDS) after receiving apparently adequate treatment for meningitis.Design: Blood, urine, and cerebrospinal fluid were cultured at the conclusion of primary therapy to assess the adequacy of treatment.Setting: Outpatient clinics at three medical centers.Patients: Patients had C. neoformans grown in culture from cerebrospinal fluid. Primary therapy consisted of either 2.0 g of amphotericin B alone; 6 weeks of combination therapy with flucytosine; or, if flucytosine was poorly tolerated, an adjusted minimum total amphotericin B dose. To meet criteria for adequate treatment of meningitis all patients had two sequential cerebrospinal fluid samples which were culture negative.Measurements and Main Results: Nine of forty-one patients grew C. neoformans from urine after completion of primary treatment, but none had urinary symptoms. Fungi were visualized in expressed prostatic secretions in 4 of these patients. One patient refused further treatment and developed cryptococcemia within 5 weeks. Three patients received additional amphotericin B; all had persistent funguria without systemic relapse. Six patients received fluconazole; 4 became urine culture negative, and 2 had systemic relapse.Conclusion: The persistence of urinary C. neoformans after adequate therapy for meningitis suggests that the urinary tract (probably the prostate) is a sequestered reservoir of infection from which systemic relapse may occur. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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