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5-fluorocitosina e anfotericina-B no tratamento da criptococose do sistema nervoso central

Amphotericin-B and 5-fluorocytosine in the treatment of cryptococcosis of the central nervous system: report of two cases

Resumos

Registro de dois casos de criptococose do sistema nervoso central, em um deles associada a candidíase. Em ambos foram utilizados no tratamento anfotericina-B e 5-fluorocitosina. Em função dos resultados obtidos são feitas considerações quanto à utilidade de cada uma das drogas no tratamento da criptococose, bem como quanto ao uso associado de ambas.


Two cases of cryptococcosis of the central nervous system are reported. The treatment was based on the association of amphotericin-B with 5-fluorocytosine. Details on the therapeutic proprieties of these drugs are discussed considering the results obtained. Amphotericin-B was administered intravenously and intrathecally in the two cases. The total amount of amphotericin administered intravenously in the first case was 5.375 mgm, and the oral doses of 5-fluorocytosine were not superior to 100 mgm/kg/of body weight. This patient died 130 days after the first symptoms of the disease. The second patient had been submitted previously to kidney transplantation after bilateral nephrectomy, and inmunossupressive drugs were administered to him since then. Candidiasis and cryptococcosis of the central nervous system developped two years later. 5-fluorocytosine was administered orally (200 mgm/kg of body weight) and amphotericin-B. The total amount of this drug administered intravenously was 2.00 mgm. There was complete clinical and laboratory remission of the mycoses in this case.


5-fluorocitosina e anfotericina-B no tratamento da criptococose do sistema nervoso central

Amphotericin-B and 5-fluorocytosine in the treatment of cryptococcosis of the central nervous system: report of two cases

J. P. S. NobregaI; J. A. LivramentoII; A. Spina-FrançaIII

IClínica Neurológica da Faculdade de Medicina da Universidade de São Paulo (Prof. H. M. Canelas): Médico assistente

IIClínica Neurológica da Faculdade de Medicina da Universidade de São Paulo (Prof. H. M. Canelas): Médico adido

IIIClínica Neurológica da Faculdade de Medicina da Universidade de São Paulo (Prof. H. M. Canelas): Docente Livre

RESUMO

Registro de dois casos de criptococose do sistema nervoso central, em um deles associada a candidíase. Em ambos foram utilizados no tratamento anfotericina-B e 5-fluorocitosina. Em função dos resultados obtidos são feitas considerações quanto à utilidade de cada uma das drogas no tratamento da criptococose, bem como quanto ao uso associado de ambas.

SUMMARY

Two cases of cryptococcosis of the central nervous system are reported. The treatment was based on the association of amphotericin-B with 5-fluorocytosine. Details on the therapeutic proprieties of these drugs are discussed considering the results obtained. Amphotericin-B was administered intravenously and intrathecally in the two cases.

The total amount of amphotericin administered intravenously in the first case was 5.375 mgm, and the oral doses of 5-fluorocytosine were not superior to 100 mgm/kg/of body weight. This patient died 130 days after the first symptoms of the disease.

The second patient had been submitted previously to kidney transplantation after bilateral nephrectomy, and inmunossupressive drugs were administered to him since then. Candidiasis and cryptococcosis of the central nervous system developped two years later. 5-fluorocytosine was administered orally (200 mgm/kg of body weight) and amphotericin-B. The total amount of this drug administered intravenously was 2.00 mgm. There was complete clinical and laboratory remission of the mycoses in this case.

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Clínica Neurológica — Faculdade de Medicina, Universidade de São Paulo — Caixa Postal 3.461 — 01000 São Paulo, SP — Brasil.

Apresentado ao VI Congresso Brasileiro de Neurologia, Rio de Janeiro, julho 1974.

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Datas de Publicação

  • Publicação nesta coleção
    05 Abr 2013
  • Data do Fascículo
    Set 1975
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