Lumbar puncture drainage with intrathecal injection of amphotericin B for control of cryptococcal meningitis.

Mycoses. 2011 Jul;54(4):e248-51

Authors: Yuchong C, Jianghan C, Hai W, Julin G

Abstract
Cryptococcal meningitis is a disease with high mortality and refractory to intravenous antifungal treatments with agents such as amphotericin B and fluconazole. We investigated lumbar puncture catheter drainage with an intrathecal injection of amphotericin B as a treatment for cryptococcal meningitis. All of the 14 patients enrolled in the treatment group survived with no evidence of relapse during 1-year follow-up. Complications included lumbosacral nerve root irritation in seven patients and urinary retention in seven patients. This study demonstrated that the technique used was effective in controlling the symptoms. The major complications disappeared after discontinuation of intrathecal injection of amphotericin B or with low-dose therapy. Therefore, this technique could be an effective and safe method for the treatment of cryptococcal meningitis.

PMID: 20070534 [PubMed - indexed for MEDLINE]

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Allergic bronchopulmonary aspergillosis complicating chronic obstructive pulmonary disease.

Mycoses. 2008 Jan;51(1):83-5

Authors: Agarwal R, Srinivas R, Jindal SK

Allergic bronchopulmonary aspergillosis (ABPA) is a well recognised entity which complicates the course of 1-2% of patients with asthma and 2-15% of cystic fibrosis. Also, current criteria generally require the presence of asthma or cystic fibrosis for recognition of ABPA. The occurrence of ABPA in conditions other than cystic fibrosis or bronchial asthma is rare. Patients with chronic obstructive pulmonary disease (COPD) have mucus hypersecretion and impaired mucociliary clearance but are not reported to develop ABPA. Herein, we report a 50-year-old male who presented with an exacerbation of COPD due to co-existent ABPA. To our knowledge, this is the first report of such an association. We also speculate on mechanisms of causality and impact of ABPA on disease progression in COPD.

PMID: 18076603 [PubMed - indexed for MEDLINE]