amphotericin-b and Focal-Infection

The purpose of this case report was to report a case of Cryptococcus laurentii infection in the left knee of a previously healthy 29 year old male patient.. After an initial misdiagnosis and 7 months of failed treatment, the patient received nearly a month of treatment with voriconazole (200 mg IV q12 h) and knee irrigation with amphotericin B until the infection was controlled. The treatment continued with fluconazole for nearly 7 months and approximately 5 weeks of antibiotic treatment for a skin bacterial coinfection. In the end, the patient's symptoms disappeared completely, the left knee recovered well, and there was no recurrence of infection.. The key points of successful treatment in this case were the thorough debridement, the adequate course of knee irrigation with antifungal drugs and more than 6 months of oral antifungal drugs that were able to eradicate the infection.

Topics: Administration, Oral; Adult; Amphotericin B; Antifungal Agents; Arthritis, Infectious; Cryptococcosis; Cryptococcus; Debridement; Diagnostic Errors; Fluconazole; Focal Infection; Humans; Knee; Male; Skin Diseases, Bacterial; Voriconazole

Topics: Adult; Amphotericin B; Candidiasis; Drug Carriers; Female; Focal Infection; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Liposomes; Liver Diseases

Cryptococcal meningoencephalitis (CM) is a fatal disease if untreated. We have presented an unusual case of CM clinically diagnosed as transient ischemic attacks. Therapy with amphotericin B and flucytosine cured the infection and the patient had no further episodes of transient focal cerebral dysfunction. In patients with transient focal cerebral symptoms, study of the cerebrospinal fluid may prove helpful.

Topics: Amphotericin B; Cryptococcosis; Flucytosine; Focal Infection; Humans; Ischemic Attack, Transient; Male; Meningoencephalitis; Middle Aged