Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso

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...

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Autores principales:	Téllez R.,María, Salgueiro C.,Catalina, Leiva Hernández,Marcelo, Fica,Alberto
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Acquired Immunodeficiency Syndrome Drug monitoring Immune Reconstitution Inflammatory Syndrome Meningitis, Cryptococcal Voriconazole
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001201481
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spelling	oai:scielo:S0034-988720180012014812019-02-18Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un casoTéllez R.,MaríaSalgueiro C.,CatalinaLeiva Hernández,MarceloFica,Alberto Acquired Immunodeficiency Syndrome Drug monitoring Immune Reconstitution Inflammatory Syndrome Meningitis, Cryptococcal Voriconazole 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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.12 20182018-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001201481es10.4067/s0034-98872018001201481
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acquired Immunodeficiency Syndrome Drug monitoring Immune Reconstitution Inflammatory Syndrome Meningitis, Cryptococcal Voriconazole
spellingShingle	Acquired Immunodeficiency Syndrome Drug monitoring Immune Reconstitution Inflammatory Syndrome Meningitis, Cryptococcal Voriconazole Téllez R.,María Salgueiro C.,Catalina Leiva Hernández,Marcelo Fica,Alberto Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso
description	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.
author	Téllez R.,María Salgueiro C.,Catalina Leiva Hernández,Marcelo Fica,Alberto
author_facet	Téllez R.,María Salgueiro C.,Catalina Leiva Hernández,Marcelo Fica,Alberto
author_sort	Téllez R.,María
title	Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso
title_short	Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso
title_full	Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso
title_fullStr	Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso
title_full_unstemmed	Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso
title_sort	criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. reporte de un caso
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001201481
work_keys_str_mv	AT tellezrmaria criptococosiscerebralvoriconazolnivelesplasmaticosysindromedereconstitucioninmunereportedeuncaso AT salgueiroccatalina criptococosiscerebralvoriconazolnivelesplasmaticosysindromedereconstitucioninmunereportedeuncaso AT leivahernandezmarcelo criptococosiscerebralvoriconazolnivelesplasmaticosysindromedereconstitucioninmunereportedeuncaso AT ficaalberto criptococosiscerebralvoriconazolnivelesplasmaticosysindromedereconstitucioninmunereportedeuncaso
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Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso

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