Central nervous system aspergillosis in an immunocompetent patient: cure in a hospice setting with very high-dose itraconazole
| Autor: | Akilesh Palanisamy, Stephanie D. Chao, Michelle M. Fouts, Derek Kerr |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Pediatrics Palliative care Antifungal Agents Time Factors Nausea Itraconazole 030106 microbiology Aspergillosis 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Cerebellar Diseases Amphotericin B Medicine Humans Neuroaspergillosis business.industry Aspergillus fumigatus General Medicine Hepatitis C medicine.disease Regimen Hospice Care Treatment Outcome Anesthesia Neurosurgery medicine.symptom business Immunocompetence medicine.drug |
| Zdroj: | The American journal of hospicepalliative care. 22(2) |
| ISSN: | 1049-9091 |
| Popis: | Aspergillosis of the central nervous system (CNS) is a rare condition with exceedingly high mortality. This study describes the case of an immunocompetent 42-year-old man with a history of intravenous drug use and hepatitis C who developed multiple Aspergillus lesions in the cerebellum. Despite neurosurgery and antifungal therapy with amphotericin B, he had a protracted hospital course with multiple complications, eventually developing cognitive and motor impairment due to progressive cerebellar lesions. After transfer to hospice and palliative care service, oral itraconazole was escalated to 1600 mg/day with the hope of palliating headache, nausea, and cognitive impairment. Remarkably, the patient stabilized and improved over time. After 14 months, this unprecedented high-dose regimen was discontinued, and the patient was discharged home with only mild cerebellar motor impairment. |
| Databáze: | OpenAIRE |
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