Cryptococcosis
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
- Studies
- Serum
- Cryptococcal antigen testing (95% Sn)
Treatment
- Amphotericin B 0.7mg/kg IV QD x2wk AND flucytosine 25mg/kg IV QID x2wk
Disposition
- Admit
Source
- Tintinalli