Triple therapy combined with ventriculoperitoneal shunts can improve neurological function and shorten hospitalization time in non-HIV cryptococcal meningitis patients with increased intracranial pressure release_cnp5444xlbhztlv5aalkdkdzpq

by Min Li, Jia Liu, Xuhui Deng, Qingzhou Gan, Yijie Wang, Xiaofeng Xu, Ying Jiang, Fuhua Peng

Released as a post by Research Square.



<jats:title>Abstract</jats:title> <jats:bold>Background:</jats:bold> Raised intracranial pressure (ICP) and insufficient antifungal regimens are the two main factors result to unsatisfactory outcomes in non-HIV cryptococcal meningitis (CM) patients. In this study, we try to discuss that whether triple therapy of amphotericin B (AmB), fluconazole, 5-flucytosine (5-FC) plus ventriculoperitoneal shunts (VPS) is superior to AmB, 5-FC, fluconazole plus intermittent lumbar puncture in induction therapy in non-HIV CM patients with increased ICP. <jats:bold>Methods:</jats:bold> We reviewed 66 clinical records from non-HIV CM patients with increased ICP. The demographic and clinical characteristics, BMRC staging, cerebrospinal fluid profiles (CSF), brain magnetic resonance imaging, treatment, and outcomes of these individuals were retrospectively analyzed. All non-HIV CM patients with increased ICP (≥ 25 cmH2O) were divided into two groups, including 27 patients treated with triple antifungal agents and 39 patients treated with the same triple therapy plus VPS. <jats:bold>Results:</jats:bold> Triple therapy plus VPS group had more satisfactory outcomes, more CSF sterilization at 10 weeks follow-up, lower CSF opening pressure, lower BMRC staging scores one week after VPS, less CSF C. neoformans counts and CSF culture positive. Besides, these patients had shorter hospital stay than triple therapy group. <jats:bold>Conclusions:</jats:bold><jats:italic> </jats:italic>Triple antifungal agents combined with VPS could effectively reduce ICP, had faster rate of clearance of C. neoformans counts, more improved neurological function, shorten hospitalization time and better outcomes in non-HIV CM patients with increased ICP. Our study indicated that triple therapy plus early VPS may be an optimal treatment for non-HIV CM patients with increased ICP.
In application/xml+jats format

Archived Files and Locations

application/pdf  416.2 kB
file_56qrvtux3vfbvkwo6eqcoy4t2i (publisher) (webarchive)
Read Archived PDF
Preserved and Accessible
Type  post
Stage   unknown
Date   2020-10-19
Work Entity
access all versions, variants, and formats of this works (eg, pre-prints)
Catalog Record
Revision: b458603f-3dea-4c72-8b92-ca4bc7a8dbf0