Biniek R, Hilgenstock F, Schuchardt V
Nervenarzt. 1986 Jan;57(1):47-55.
Cryptococcal meningitis is a life-threatening disease. Headache, vomiting, cranial nerve symptoms and mental changes are the most common symptoms, but as many as 15% may have no symptoms referable to the CNS. For chemotherapy four drugs are available: namely amphotericin B, 5-fluorocytosine, miconazole and ketoconazole. Most cases have been treated by combination of amphotericin B and 5-fluorocytosine. The intrathecal administration of amphotericin B should be considered for patients who fail to respond to the usual intravenous therapy. The case is reported of a patient who died due to hydrocephalus, and the CSF-levels of the administered drugs are presented. Some pitfalls of therapy are discussed.
隐球菌性脑膜炎是一种危及生命的疾病。头痛、呕吐、脑神经症状和精神改变是最常见的症状，但多达15%的患者可能没有中枢神经系统相关症状。用于化疗的药物有四种：即两性霉素B、5-氟胞嘧啶、咪康唑和酮康唑。大多数病例采用两性霉素B和5-氟胞嘧啶联合治疗。对于常规静脉治疗无效的患者，应考虑鞘内注射两性霉素B。本文报道了一例因脑积水死亡的患者，并列出了所使用药物的脑脊液水平。同时讨论了治疗中的一些陷阱。
