Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso
- Autores: María Téllez R., Catalina Salgueiro C., Marcelo Leiva Hernández, Alberto Fica C
- Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 146, Nº. 12, 2018, págs. 1481-1485
- Idioma: español
- Títulos paralelos:
- Cerebral cryptococcosis and immune reconstitution inflammatory syndrome. Case report
- Enlaces
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Resumen
We report a 45-year-old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycholate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma levels of voriconazole were insufficient with a standard dose (0.7 μg/mL), therefore, the dose was increased thereafter to reach appropriate levels (4.5 μg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.
