Cryptococcal meningitis: complications due to intrathecal treatment

Abstract

A 50-year-old woman with cryptococcal meningitis was treated with amphotericin B intrathecally through a Rickham reservoir and intravenously, together with flucytosine orally. After 4 months of treatment cryptococci and cryptococcal antigen were still present in cerebrospinal fluid from time to time. After removal of the Rickham reservoir the patient recovered completely within 6 weeks. The persistent infection was thus found to be due to the presence of the Rickham reservoir, a complication to intrathecal therapy which has not been reported before.