We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Persistent Cryptococcus neoformans infection of the prostate after successful treatment of meningitis. California Collaborative Treatment Group.
- Authors
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
- Abstract
<bold>Study Objective: </bold>To assess the frequency of persistent Cryptococcus neoformans infection in patients with the acquired immunodeficiency syndrome (AIDS) after receiving apparently adequate treatment for meningitis.<bold>Design: </bold>Blood, urine, and cerebrospinal fluid were cultured at the conclusion of primary therapy to assess the adequacy of treatment.<bold>Setting: </bold>Outpatient clinics at three medical centers.<bold>Patients: </bold>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.<bold>Measurements and Main Results: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
CRYPTOCOCCUS neoformans; AIDS patients; MENINGITIS treatment; URINARY tract infections
- Publication
Annals of Internal Medicine, 1989, Vol 111, Issue 2, p125
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-111-2-125