CEREBRAL CRYPTOCOCOSIS AND IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME. CASE REPORT

Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso

Author
Téllez R, María; Universidad Austral de Chile

Salgueiro C, Catalina; Universidad Austral de Chile

Leiva Hernández, Marcelo; Hospital Base de Valdivia

Fica, Alberto; Hospital Base de Valdivia

Full text
http://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/6929
Abstract
We report a 45 years old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycolate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma voriconazole trough levels were insufficient with a standard dose (0.7 µg/mL); therefore, the dose was increased thereafter to reach appropriate levels (4.5 µg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.
 
We report a 45 years old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycolate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma voriconazole trough levels were insufficient with a standard dose (0.7 µg/mL); therefore, the dose was increased thereafter to reach appropriate levels (4.5 µg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.
 
Metadata
Show full item record