Ketoconazole treatment of coccidioidal meningitis.

Abstract:

:Fifteen patients with coccidioidal meningitis were treated with high doses of ketoconazole for up to 4 years. Five patients were treated with ketoconazole alone. One clinically failed, one developed hepatotoxicity, and three achieved remission of meningitis. One patient received intrathecal AMB in addition to ketoconazole for only 2 weeks before continuing on ketoconazole alone. He improved, but discontinued ketoconazole because of nausea and vomiting, and suffered a lethal relapse. Nine patients received ketoconazole in combination with prolonged courses of intrathecal AMB. Two patients were failures from nausea and vomiting, and the remaining seven either improved or experienced remission. The clinical responses appeared to be similar in patients receiving high-dose ketoconazole, either alone or combined with AMB, suggesting that there is no clinically significant antagonism of the drugs. Nausea and vomiting are significant limitations of high-dose ketoconazole. Ketoconazole alone is effective in some patients with coccidioidomycotic meningitis.

journal_name

Ann N Y Acad Sci

authors

Graybill JR,Stevens DA,Galgiani JN,Sugar AM,Craven PC,Gregg C,Huppert M,Cloud G,Dismukes WE

doi

10.1111/j.1749-6632.1988.tb40446.x

subject

Has Abstract

pub_date

1988-01-01 00:00:00

pages

488-96

eissn

0077-8923

issn

1749-6632

journal_volume

544

pub_type

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