This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Meningitis is inflammation of the subarachnoid space, the fluid bathing the brain (between the arachnoid and the pia mater; figure above). Amphotericin B (0.71 mg/kg given iv daily for 2 weeks) combined with flucytosine, 100 mg/kg given orally in 4 divided doses per day, is the initial treatment of choice [11, 13, 18, 29] (AI). Serum procalcitonin, serum C-reactive protein, and CSF lactate levels can be useful in distinguishing between aseptic and bacterial meningitis.2833 C-reactive protein has a high negative predictive value but a much lower positive predictive value.28 Procalcitonin is sensitive (96%) and specific (89% to 98%) for bacterial causes of meningitis.29,30 CSF lactate also has a high sensitivity (93% to 97%) and specificity (92% to 96%).3133 CSF latex agglutination testing for common bacterial pathogens is rapid and, if positive, can be useful in patients with negative Gram stain if LP was performed after antibiotics were administered. Diagnosis of meningitis is mainly based on clinical presentation and cerebrospinal fluid analysis. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. However, in patients with HIV or AIDS, the yearly incidence rate is between 2 and 7 cases per 1,000 people. Please check for further notifications by email. Cryptococcal meningitis in an immunocompetent patient The content is unchanged. Viral meningitis is generally self-limited with a good prognosis. However, in people with weakened immune systems, such as those living with HIV, Cryptococcus can stay hidden in the body and later cause a serious (but not contagious) brain infection called cryptococcal meningitis. HIV-negative, immunocompromised hosts should be treated in the same fashion as those with CNS disease, regardless of the site of involvement. Cryptococcal meningitis is a fungal infection of the tissues covering the brain and spinal cord. They help us to know which pages are the most and least popular and see how visitors move around the site. Drug acquisition costs are high for antifungal therapies administered for 612 months. There are two meningitis vaccines available in the US, and both are proven safe. Options. The serum cryptococcal antigen is positive in >99% of subjects with cryptococcal meningitis, usually at titers >1 : 2048 [11, 13]. This approach has been shown to reduce the chance of a patient developing cryptococcal meningitis. Maintain isolation precautions as necessary with bacterial meningitis. On the basis of experience of treating cryptococcal meningitis in HIV disease, it is reasonable to follow a similar induction, consolidation, and suppression strategy, since previous strategies reported failure rates of 15%20% with 6 weeks of treatment with combination amphotericin B/5-flucytosine [3].
How To Read Fannie May Expiration Date,
Modern Warfare Best Sensitivity For 800 Dpi,
Inches To Radians Calculator,
Ford Five Hundred Cvt Vs 6 Speed,
Articles C