Abstract
We recently encountered a case of cryptococcosis (cryptococcal meningitis). As a serological test, we used the latex agglutination (LA) test for antigen detection. This test is known to be useful in the diagnosis of cryptococcosis. Antigens were detected, and the time course of the titer of cryptococcal antigen in the cerebrospinal fluid aided our evaluation of the treatment. We measured miconazole and flucytosine (5-FC) concentration in serum after intravenous administration of the former or oral administration of the latter. We also measured concentration of the drugs in cerebrospinal fluid after intrasubarachnoidal space administration or intravenous administration of miconazole or oral administration of 5-FC.
Intravenous administration of a large amount of miconazole resulted in successful treatment without serious side effects. Therefore, the combination therapy of intravenous administration of a large amount of miconazole and oral administration of 5-FC is considered effective for treatment of cryptococcus meningitis.
