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J Mycol Med. 2017 Mar;27(1):72-78. doi: 10.1016/j.mycmed.2016.10.001. Epub 2017 Jan 17.

[Fluconazole 1200mg or 800mg for cryptococcal meningitis treatment in Ivory Coast].

[Article in French]

Author information

1
Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, 01 BP V3 Abidjan 01, Côte d'Ivoire; Unité de formation et de recherche, des sciences médicales, département de dermatologie-infectiologie, université Félix Houphouët, Boigny d'Abidjan, 01 BP V166 Abidjan 01, Côte d'Ivoire. Electronic address: gisele_affoue@yahoo.fr.
2
Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, 01 BP V3 Abidjan 01, Côte d'Ivoire; Unité de formation et de recherche, des sciences médicales, département de dermatologie-infectiologie, université Félix Houphouët, Boigny d'Abidjan, 01 BP V166 Abidjan 01, Côte d'Ivoire.
3
Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, 01 BP V3 Abidjan 01, Côte d'Ivoire.
4
Centre de diagnostic et de recherche sur le sida et maladies opportunistes, centre hospitalier universitaire de Treichville, 01 BP V3 Abidjan, Côte d'Ivoire.

Abstract

OBJECTIVE:

Assessing the use of high-dose fluconazol monotherapy (1200mg or 800mg) in the treatment and prognosis of HIV-associated cryptococcal meningitis in Ivory Coast.

PATIENTS AND METHODS:

A retrospective study carried out from August 2008 to August 2011 based on patients charts suffering from CM in the Abidjan Tropicals and Infectious Disease Unit. Mortality rate and associated factors were analyzed.

RESULTS:

Forty-six cases of cryptococcal meningitis (2.5% of hospitalizations) were included. The sex-ratio was of 1.2. The median age was 40.5 [35-47] years. The symptomatology was subacute (93.5%). The main clinical symptoms were syndrome of pure meningeal irritation (65%), fever (100%); 35% of patients had encephalomeningits. Twenty-one (45.7%) was ART-naïve patients. Fluconazole 1200mg was prescribed to 29 (63%) patients. Therapeutic lumbar punctures were performed in 42 (91.3) patients. The mortality rate was 50%. Significant predictors of mortality were encephalomeningitis and therapeutic lumbar puncture.

CONCLUSION:

Cryptococcal meningitis associated mortality remains high despite the use of high-dose fluconazole monotherapy. Therapeutic lumbar punctures help to improving the prognosis.

KEYWORDS:

Cryotococcal meningitis; Cryptococcose neuroméningée; Côte d’Ivoire; Fluconazol; Fluconazole; HIV; Ivory Coast; VIH

PMID:
28108201
DOI:
10.1016/j.mycmed.2016.10.001
[Indexed for MEDLINE]

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