Intrathecal injection of amphotericin B in treatment of patients with cryptococcal meningitis

Objective To investigate the clinical characterizes,effect and treatment of patients with cryptococcal meningitis.Methods Three patients with cryptococcal meningitis from September 2010 to May 2012 were selected,and their clinical characteristics and therapy were reviewed.The cerebrospinal fluids samples were collected from these patients.Ink stain in CSF was positive in all patients.Results The clinical manifestation of 3 patients showed to be complication,including fever,headache and vomiting.One patient had diplopia,drowsiness,coma,spasm.Ink stain in CSF was positive in three patients.The Cryptococcus neoformans was detected from the CSF of 1 patient,2 patients had abnormal signals in cerebral parenchyma,2 patients were inserted intravenous drips with amphotercin B and fluconazole,took 5-flucytosine.When these 2 patients got worse or phlebitis,amphotercin B was used through intrathecal injection,1 patient after diagnose was treated with intrathecal injection,now 3 patients had been cured.Conclusions The clinical symptoms of patients with cryptococcal meningitis or cryptococcal vaccination are various and atypical,some patients can not express symptoms exactly due to little age,so it is easy to miss diagnose and delay treatment,when it gets worse with intravenous injection,intrathecal injection can control and cure this disease though treatment costs too long time. Key words: Cryptococcal meningitis; Amphotercin B; Fluconazole; 5-flucytosine; Intrathecal injection