Resumo

TELLEZ R., María; SALGUEIRO C., Catalina; LEIVA HERNANDEZ, Marcelo  e  FICA, Alberto. Cerebral cryptococcosis and immune reconstitution inflammatory syndrome. Case report. Rev. méd. Chile [online]. 2018, vol.146, n.12, pp.1481-1485. ISSN 0034-9887.  http://dx.doi.org/10.4067/s0034-98872018001201481.

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.

Palavras-chave : Acquired Immunodeficiency Syndrome; Drug monitoring; Immune Reconstitution Inflammatory Syndrome; Meningitis, Cryptococcal; Voriconazole.

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