PMID: 3214090Jan 1, 1988Paper

Ketoconazole treatment of coccidioidal meningitis

Annals of the New York Academy of Sciences
J R GraybillW E Dismukes

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.

References

Dec 1, 1987·Antimicrobial Agents and Chemotherapy·A M SugarD A Stevens
Jan 25, 1973·The New England Journal of Medicine·R D Diamond, J E Bennett
Nov 7, 1968·The New England Journal of Medicine·R A Ratcheson, A K Ommaya
Jul 1, 1968·Journal of Neurosurgery·D L Kelly, E Alexander
Feb 1, 1983·Annals of Internal Medicine·P C CravenB E Levine

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Citations

May 1, 1989·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·J R Graybill
Jun 24, 2009·Current Infectious Disease Reports·Janis E Blair
Dec 3, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Royce H Johnson, Hans E Einstein
May 1, 1990·Antimicrobial Agents and Chemotherapy·K V ClemonsD A Stevens
Jun 23, 2011·International Journal of Environmental Research and Public Health·Richard F HectorJohn N Galgiani
Mar 9, 2007·Annals of the New York Academy of Sciences·John N Galgiani
May 22, 2007·Annals of the New York Academy of Sciences·Royce H Johnson, Hans E Einstein
Jan 1, 1992·Journal of Medical and Veterinary Mycology : Bi-monthly Publication of the International Society for Human and Animal Mycology·A M SugarT F Patterson
Apr 1, 1996·Clinical Microbiology Reviews·A Espinel-Ingroff

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