【歐拉拉】評論

隱球菌腦膜炎(隱球菌Cryptococc☆☆...

【yu】評論

<From Uptodate> CONTROL OF INTRACRANIAL PRESSURE：Control of intracranial pressure is one of the most critical determinants of outcome for cryptococcal meningoencephalitis [18,48]. The intracranial pressure should be measured at the time of initial lumbar puncture. If the pressure is ≥25 cm of cerebrospinal fluid (CSF) and there are symptoms of increased intracranial pressure during induction therapy, CSF drainage should be performed to reduce the pressure by 50 percent (if extremely high) or to a normal pressure of ≤20 cm [1].<正確處置的部分>Therapeutic lumbar drainage should ...

【er223337】評論

中樞神經隱球菌感染：Ampbtericin B + Flucytosine 2週 之後鞏固治療服用Fluconazole 8週

【貓】評論

若CSF pressure>250 mm H2O(25 cm H2O)，建議反覆LP(lumbar puncture)引流以控制腦壓CSF pressure升高與高死亡率有正向關聯，若臨床不便反覆LP，也可以考慮使用V-P shunt(ventriculoperitoneal shunt腦室腹腔分流術；使用分流管將脊隨液由腦室引流至腹腔，以降低腦壓)補充:隱球菌腦膜炎的藥物治療會看到Ampho B-based regimen但要注意不同的Ampho B 製劑會有不同的劑量建議以下:Ampho B(ampho B deoxycholate): 0.7mg/kg IV q24h(以HIV+ cryptococcemia 用法用量為例)ABLC(ampho B lipid complex): 5mg/kg IV q24hABCD(ampho B cholesteryl sulfate complex)L-AMB(liposomal ampho B): 3-4mg/kg IV q24h構造差異圖片請見:https://slideplayer....