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Case Reports
. 2020 Feb:72:455-457.
doi: 10.1016/j.jocn.2020.01.028. Epub 2020 Jan 14.

Successful treatment with corticosteroids for refractory deterioration of cryptococcal meningitis with an increasing cryptococcal antigen titer

Yoshiaki Takahashi  1 , Nobutoshi Morimoto  2 , Motonori Takamiya  2 , Mizuki Morimoto  2 , Satoshi Mino  3 , Satoshi Kuramoto  3 , Masamitsu Kawauchi  3 , Kyoko Yokota  4 , Koji Abe  5
Affiliations
Case Reports

Successful treatment with corticosteroids for refractory deterioration of cryptococcal meningitis with an increasing cryptococcal antigen titer

Yoshiaki Takahashi et al. J Clin Neurosci. 2020 Feb.

Abstract

We report a 55-year-old man with Cryptococcus neoformans meningitis who showed refractory deterioration twice with an increased cerebrospinal fluid cryptococcal antigen titer during the course of treatment. Although the initial deterioration was temporarily improved by placement of a ventriculoperitoneal shunt, he experienced deterioration again. However, he improved after administration of systemic corticosteroids. The present case suggests that systemic corticosteroid can be a choice of treatment to rescue immunocompetent patients with Cryptococcus neoformans meningitis and severe deterioration, even if cerebrospinal fluid analysis shows an increased cryptococcal antigen titer.

Keywords: Corticosteroid; Cryptococcal antigen titer; Cryptococcus neoformans meningitis; Refractory deterioration; Ventriculoperitoneal shunt.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Comment in

  • Steroid in cryptococcal meningitis.
    Kumar Mishra A, Lal A, Kant Sahu K. Kumar Mishra A, et al. J Clin Neurosci. 2020 Jun;76:255-256. doi: 10.1016/j.jocn.2020.04.032. Epub 2020 Apr 11. J Clin Neurosci. 2020. PMID: 32291241 No abstract available.

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