Journal
MEDICAL MYCOLOGY CASE REPORTS
Volume 19, Issue -, Pages 30-32Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.mmcr.2017.11.004
Keywords
Cryptococcus; Cryptococcal meningitis; Antifungal susceptibility; Fluconazole resistance; Cryptococcal meningitis relapse
Categories
Funding
- National Institutes of Neurologic Diseases and Stroke and Fogarty International Center [R01NS086312, K01TW010268, R25TW009345]
- FOGARTY INTERNATIONAL CENTER [K01TW010268, R25TW009345] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [T32AI055433] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS086312] Funding Source: NIH RePORTER
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We present the case of an HIV-seropositive individual with cryptococcal meningitis who was found to have a fluconazole resistant strain of Cryptococcus neoformans. The individual required multiple rounds of amphotericin and fluconazole 800-1200 mg after several episodes of clinical relapse. Cerebrospinal fluid sterilization was achieved and maintained with high doses of fluconazole. This case demonstrates the emerging dilemma of increasing rates of fluconazole resistance in Cryptococcus and the clinical difficulties in meningitis management.
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