Development of Secondary Resistance to Fluconazole in Cryptococcus neoformans Isolated from a Patient with AIDS

Author(s): ALVES Sydney H., LOPES Jorge O., COSTA Jane M., KLOCK Clóvis
Keywords: Cryptococcus neoformans, Secondary resistance, Fluconazole
Journal: Revista do Instituto de Medicina Tropical de São Paulo
Year: 1997
Full text: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46651997000600010
Publisher: Instituto de Medicina Tropical
Abstract: Cryptococcus neoformans is the fifth most common opportunistic agent of infection in patients with AIDS in the USA, exceeded only by Candida species, Pneumocystis carinii, cytomegalovirus and Mycobacterium avium1, 2, 6, 10, 11. In Brazil is the sixth, exceeded by Candida species, P. carinii, Mycobacterium species, Toxoplasma gondii, and herpes simplex virus (AIDS, Boletim Epidemiológico, set/nov 96, Ministærio da Saúde, Brasil). During 30 years, the treatment of C. neoformans meningitis was based on the use of amphotericin B with or without flucytosine13. Nowadays, with the immunodepression caused by human immunodeficiency virus (HIV) infection and the availability of new antifungal drugs as the triazoles, the concept related to cure and relapses of cryptococcosis has been altered7, 20. Patients are treated with amphotericin B with or without flucytosine as initial therapy, but maintenance therapy is always necessary in AIDS patients with C. neoformans infections