Boletín médico del Hospital Infantil de México
versión impresa ISSN 1665-1146
GOMEZ RIVERA, Norberto; DORAME CASTILLO, Roberto; CONTRERAS SOTO, Jesús y TALAMANTE, Sandra. Treatment of meningeal coccidiomycosis with liposomal amphotericin: case report. Bol. Med. Hosp. Infant. Mex. [online]. 2010, vol.67, n.2, pp.142-146. ISSN 1665-1146.
Background: Coccidioidomycosis was first described in the late 18th century by Alejandro Posadas. The first case in Sonora was reported in 1948 by Madrid. Coccidioidomycosis is caused by both species of a dimorphic fungus, one limited to the California area (C.immitis) and the other a non-California strain (C. posadassi). Clinical case: A 6-year-old male patient from Caborca, Sonora presented headache and projectile vomiting. At 2½ years of age he was treated at a hospital with the diagnosis of undetermined hydrocephalus. At 3½ years of age, a diagnosis of coccidioidal meningitis was made without knowing the serum antibody and cerebrospinal fluid (CSF) titers. He received treatment with fluconazole for 3 years with 1 month of amphotericin B deoxycholate. Upon admission to our hospital, elevated antibody CSF titers were present. Conclusion: After being treated with liposomal amphotericin (2 mg/kg) for 9 months, he reached a total dose of 5475 mg, presenting good clinical outcome with decreased serum antibodies and CSF titers. During his treatment no clinical or laboratory data suggested toxicity due to liposomal amphotericin administration.
Palabras llave : coccidioidomycosis; cerebrospinal fluid; fluconazole; liposomal amphotericin.