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M94A2659.TXT
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1994-10-25
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Document 2659
DOCN M94A2659
TI Cryptococcosis in HIV infected children.
DT 9412
AU Valada MG; Nunes C; Jacob CM; Del Negro G; Marques HH; Grumach AS;
Aquino MZ; Dept. Pediatrics & Microbiology, Univ Sao Paulo, Brazil.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):254 (abstract no. PB0446). Unique
Identifier : AIDSLINE ICA10/94369916
AB Cryptococcosis is an unnusual disease in children but its incidence is
increasing since the advent of AIDS. The authors report four cases of
Cryptococcosis in HIV infected children diagnosed between 1985 and 1994
among 170 children followed in our servicein this period. The patients
were 9 and 11 years old with blood products transmission, and 3 and 7
years old in perinatally contamination. In one case, neurocryptococcosis
had been the first manifestation of AIDS. All the children had
neurological symptoms. The diagnosis was confirmed by CSF culture and in
3 cases the Latex aglglutination test was positive with high titers
bellow 1/500. After the beginning of the treatment, the serologic titers
fell to 1/40 or less, despite of the cultures that remained positive for
a prolonged period (45 days or more). The drug of choice to initiate the
treatment was AmphoB. In one case 5FC was associated without response.
The use of intrathecal AmphoB was performed with good results. Long term
suppressive therapy was not instituted and relapsed occourred. The
response to further treatment with AmphoB and 5FC was good. The second
child died 4 days after the diagnosis. The other two children received
AmphoB during 40 and 50 days respectively and it was discontinued due to
intolerance and side effects. Fluconazole was initiated with good
results and mainteined in the suppressive therapy. The authors emphasize
the increasing importance of C. neoformans infection in children with
AIDS and the need to be aware about the problems in the management and
follow-up of these cases, especially the long time spent to the
sterilization of CSF and the importance of long term suppresseve
therapy.
DE Amphotericin B/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS AIDS-Related
Opportunistic Infections/*DIAGNOSIS/DRUG THERAPY/ MORTALITY Brazil
Child Child, Preschool Cryptococcosis/*DIAGNOSIS/DRUG
THERAPY/MORTALITY Dose-Response Relationship, Drug Female
Fluconazole/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Human Male
Survival Rate MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).