The treatment of a pregnant HIV positive patient with cryptococcal meningitis in Malawi. Case report and review of treatment options

被引：4

作者：

Bright, Philip D. ^{[1
]}

Lupiya, Duncan ^{[2
]}

van Oosterhout, Joep J. ^{[2
,3
]}

Chen, Amy ^{[4
]}

Harrison, Thomas S. ^{[1
]}

Chan, Adrienne K. ^{[2
,5
]}

机构：

[1] St Georges Univ London, Inst Infect & Immun, Cranmer Terrace, London SW17 0RE, England

[2] Dignitas Int, Zomba, Malawi

[3] Univ Malawi, Dept Med, Coll Med, Blantyre, Malawi

[4] Univ Toronto, Trillium Hlth Partners, Toronto, ON, Canada

[5] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med, Div Infect Dis, Toronto, ON, Canada

来源：

MEDICAL MYCOLOGY CASE REPORTS | 2018年 / 19卷

基金：

英国医学研究理事会;

关键词：

Cryptococcal meningitis; Pregnancy; Treatment; HIV; Malawi;

D O I：

10.1016/j.mmcr.2017.10.002

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

This case reports cryptococcal meningitis in an HIV positive woman on antiretroviral therapy, presenting with left middle cerebral artery stroke at 30 weeks gestation. The patient had well-controlled HIV (CD4 count over 200 cells/mL). The immunosuppressive effects of the pregnancy likely contributed to the development of cryptococcal disease. The patient was successfully treated with two weeks of amphotericin B followed by fluconazole, delivered a healthy baby, but remained with a permanent severe neurological deficit.

引用

页码：9 / 12

页数：4

共 20 条

[1] Pregnancy and the Immune System: General Overview and the Gastroenterological Perspective
Adar, Tomer
Grisaru-Granovsky, Sorina
Ben Ya'acov, Ami
Goldin, Eran
Shitrit, Ariella Bar-Gil
[J]. DIGESTIVE DISEASES AND SCIENCES, 2015, 60 (09) : 2581 - 2589
[2] Expansion of CD4+CD25+ and FOXP3+ regulatory T cells during the follicular phase of the menstrual cycle:: Implications for human reproduction
Arruvito, Lourdes
Sanz, Marianela
Banham, Alison H.
Fainboim, Leonardo
[J]. JOURNAL OF IMMUNOLOGY, 2007, 178 (04) : 2572 - 2578
[3] Acute/subacute cerebral infarction (ASCI) in HIV-negative adults with cryptococcal meningoencephalitis (CM): a MRI-based follow-up study and a clinical comparison to HIV-negative CM adults without ASCI
Chen, Shu-Fang
Lu, Cheng-Hsien
Lui, Chun-Chung
Huang, Chi-Ren
Chuang, Yao-Chung
Tan, Teng-Yeow
Tsai, Nai-Wen
Chang, Chiung-Chih
Tsai, Wan-Chen
Chang, Wen-Neng
[J]. BMC NEUROLOGY, 2011, 11
[4] Pulmonary Cryptococcosis in HIV- sero-negative patients: case series from India
Chopra, Shimpi
Capoor, Malini R.
Mallik, Rupali
Gupta, Sonal
Ray, Animesh
Khanna, Geetika
Suri, J. C.
Bhattacharya, D.
Raghavan, Samudrala
[J]. MYCOSES, 2015, 58 (05) : 288 - 293
[5] Cryptococcal pneumonia complicating pregnancy
Ely, EW
Peacock, JE
Haponik, EF
Washburn, RG
[J]. MEDICINE, 1998, 77 (03) : 153 - 167
[6] A Prospective Study of the Effect of Pregnancy on CD4 Counts and Plasma HIV-1 RNA Concentrations of Antiretroviral-Naive HIV-1-Infected Women
Heffron, Renee
Donnell, Deborah
Kiarie, James
Rees, Helen
Ngure, Kenneth
Mugo, Nelly
Were, Edwin
Celum, Connie
Baeten, Jared M.
[J]. JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 2014, 65 (02) : 231 - 236
[7] Kaplan YC, 2015, CAN FAM PHYSICIAN, V61, P875
[8] Unmasking cryptococcal meningitis immune reconstitution inflammatory syndrome in pregnancy induced by HIV antiretroviral therapy with postpartum paradoxical exacerbation
Kiggundu, Reuben
Rhein, Joshua
Meya, David B.
Boulware, David R.
Bahr, Nathan C.
[J]. MEDICAL MYCOLOGY CASE REPORTS, 2014, 5 : 16 - 19
[9] Antifungal therapy during pregnancy
King, CT
Rogers, PD
Cleary, JD
Chapman, SW
[J]. CLINICAL INFECTIOUS DISEASES, 1998, 27 (05) : 1151 - 1160
[10] Prenatal exposure to fluconazole: An identifiable dysmorphic phenotype
Lopez-Rangel, E
Van Allen, MI
[J]. BIRTH DEFECTS RESEARCH PART A-CLINICAL AND MOLECULAR TERATOLOGY, 2005, 73 (11) : 919 - 923

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