Cryptococcosis: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
*Neuroimaging usually normal | *Neuroimaging usually normal | ||
*CSF | *'''CSF Studies''' | ||
**Crypto antigen (100% Sn & Sp) | |||
**Crypto culture (95%-100% Sn) | |||
**India Ink (60-80% Sn) | |||
*Opening pressure | |||
**Usually elevated; drain CSF until pressure is <20 or 50% of opening presure | |||
*'''Serum''' | |||
*Serum | |||
**Cryptococcal antigen testing (95% Sn) | **Cryptococcal antigen testing (95% Sn) | ||
Revision as of 14:28, 22 March 2015
Background
- Can produce focal cerebral lesions or diffuse meningoencephalitis
Clinical Features
- Fever
- Headache
- Nausea
- AMS
- Focal neurologic deficits
Diagnosis
- Neuroimaging usually normal
- CSF Studies
- Crypto antigen (100% Sn & Sp)
- Crypto culture (95%-100% Sn)
- India Ink (60-80% Sn)
- Opening pressure
- Usually elevated; drain CSF until pressure is <20 or 50% of opening presure
- Serum
- Cryptococcal antigen testing (95% Sn)
Treatment
- Amphotericin B 0.7mg/kg IV QD x 2 weeks
- Flucytosine 25mg/kg IV QID x2wk
- Fluconazol 200mg BID x 8 weeks to clear CSF
Disposition
- Admit
Source
- Tintinalli