Usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment

作者：Nakama Tatsuya; Yamashita Satoshi^*; Hirahara Tomoo; Okamoto Sadahisa; Honda Shoji; Watanabe Masaki; Kimura En; Uchino Makoto; Yano Shigetoshi; Kuratsu Jun ichi; Ando Yukio

来源：Journal of the Neurological Sciences, 2015, 358(1-2): 259-262.

DOI：10.1016/j.jns.2015.09.005

• Cryptococcus neoformans
• Cryptococcal meningitis
• Ommaya reservoir
• Intraventricular injection
• Antifungal drugs
• Amphotericin B
• Outcome

Introduction: Cryptococcal meningitis is a severe infection among immunosuppressed individuals, with a high mortality rate. Although amphotericin B is the first-choice drug for treatment, its use is restricted when adverse effects are clinically problematic. The usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment has been unconfirmed. We evaluated the efficacy of intraventricular infusion of amphotericin B through Ommaya reservoirs.
Materials and methods: We retrospectively analyzed 10 consecutive patients with cryptococcal meningitis who were refractory to systemic administration of antifungal drugs.
Results: Fever or nausea occurred in most patients. However, no patient complained of serious complications such as renal toxicity. Seven patients recovered completely or partially, whereas three patients died.
Conclusions: To establish the efficacy of the intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis, a prospective investigation should be designed to compare those treated according to the updated guidelines and those treated with antifungal drugs through the Ommaya reservoirs.

• 出版日期2015-11-15