Use of cerebrospinal fluid shunt for the management of elevated intracranial pressure in a patient with active AIDS-related cryptococcal meningitis

Persistently elevated intracranial pressure (ICP) is one of the most accurate predictors of a poor prognosis in patients with AIDS-related cryptococcal meningitis. We present a severe case of persistent cryptococcal meningitis in a patient with advanced AIDS, complicated by elevation of ICP. A ventr...

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Bibliographic Details
Published in:Diagnostic microbiology and infectious disease 1999-06, Vol.34 (2), p.111-114
Main Authors: Mylonakis, Eleftherios, Merriman, Nathan A, Rich, Josiah D, Flanigan, Timothy P, Walters, Beverly C, Tashima, Karen T, Mileno, Maria D, van der Horst, Charles M
Format: Article
Language:English
Subjects:
Adult
AIDS-Related Opportunistic Infections - microbiology
AIDS-Related Opportunistic Infections - physiopathology
AIDS-Related Opportunistic Infections - therapy
AIDS/HIV
Biological and medical sciences
Human mycoses
Humans
Infectious diseases
Intracranial Pressure
Male
Medical sciences
Meningitis, Cryptococcal - physiopathology
Meningitis, Cryptococcal - therapy
Mycoses
Mycoses of the nervous system
Ventriculoperitoneal Shunt
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Summary:Persistently elevated intracranial pressure (ICP) is one of the most accurate predictors of a poor prognosis in patients with AIDS-related cryptococcal meningitis. We present a severe case of persistent cryptococcal meningitis in a patient with advanced AIDS, complicated by elevation of ICP. A ventriculoperitoneal shunt was placed that successfully lowered the ICP and alleviated the associated symptoms. The elevated ICP secondary to AIDS-related cryptococcal meningitis should be treated aggressively. Despite the risk of shunt complications, cerebrospinal fluid shunts can be considered in these patients if they do not respond to other treatment.
ISSN:0732-8893
1879-0070
DOI:10.1016/S0732-8893(99)00025-5