2005
DOI: 10.1086/427213
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Cryptococcus neoformans Meningitis at 2 Hospitals in Washington, D.C.: Adherence of Health Care Providers to Published Practice Guidelines for the Management of Cryptococcal Disease

Abstract: Meningitis due to Cryptococcus neoformans may be associated with elevated intracranial pressure (ICP), but management of this complication is often overlooked. We retrospectively analyzed 39 consecutive patients with cases of culture-proven, community-acquired meningitis and ascertained adherence to Infectious Diseases Society of America (IDSA) practice guidelines for management of cryptococcal meningitis. Of these 39 patients, 26 (67%) had infection due to C. neoformans. Cerebrospinal fluid opening pressure h… Show more

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Cited by 67 publications
(57 citation statements)
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“…9,10 Deviations in the management of raised ICP were observed in 88% of patients with poor neurological outcome. Aggressive management of raised ICP was associated with an improved outcome.…”
Section: Introductionmentioning
confidence: 99%
“…9,10 Deviations in the management of raised ICP were observed in 88% of patients with poor neurological outcome. Aggressive management of raised ICP was associated with an improved outcome.…”
Section: Introductionmentioning
confidence: 99%
“…Significant neurological decline can occur if elevated CSF pressures are inadequately managed. 28,29,33,39 Various treatment strategies to address intracranial hypertension in this setting have been described, including medical management, serial lumbar punctures, external lumbar and ventricular drain placement, and either ventricular or lumbar shunting. 26 The literature remains unclear as to when each approach is indicated and how often patients require neurosurgical intervention.…”
mentioning
confidence: 99%
“…C. neoformans capsule is considered as the major virulence factor of this intracellular pathogen. The polysaccharide capsule antigen contributes to the virulence by being antiphagocytic among other features that affect the host immune response 1,2 . Cryptococcal meningitis treatment has been primarily focused on optimizing antifungal therapy based on amphotericin B plus fl ucytosine or fl uconazole.…”
mentioning
confidence: 99%