Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 66-year-old woman was admitted to the Medical College Hospital of Oita on February 23, 1988, because of headache and fever. Chest X-P and chest CT findings showed a coin lesion in r-S4. Cryptococcus neoformans was isolated from the CSF. Abnormal lymphocytes with lobulated nuclei were found in 0-5% of peripheral leukocytes. The ATLA-antibody was positive and bone marrow smear showed normal myelogram. According to these data, we diagnosed the patient as smouldering adult T-cell leukemia accompanied with pulmonary cryptococcosis and cryptococcal meningitis. C. neoformans disappeared from the CSF and cryptococcal antigen was not detectable after Amphotericin B and Flucytosine treatment. On April 1, the patient complained of a dry cough, high fever and dyspnea. A chest X-ray showed bilateral patchy infiltrations. By the methenamine silver staining, cysts of Pneumocystis carinii were found in the specimens of transbronchial lung biopsy and bronchoalveolar lavage fluid. The abnormal shadow on chest X-ray disappeared after TMP-SMX and aerosolised pentamidine treatment.
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PMID:[A case of adult T-cell leukemia with pulmonary cryptococcosis, cryptococcal meningitis and Pneumocystis carinii pneumonia]. 250 95

Cryptococcal meningitis is the most frequent fungal infection of the central nervous system, known readily to complicate with immuno-compromised patients. There are only a few cases of primary infection in healthy non-immuno-compromised patients. Amphotericin-B (AMPH-B) and 5-Fluorocytosine (5-FC) are effective agents against Cryptococcal meningitis, although, their toxicity and drug resistance are limiting factors. However, in recent years Miconazole has been widely used against fungal infections and it's effectiveness has been reported. This is a 68 y.o. male who was admitted to Toyohashi Municipal Hospital on March 15, 1987 because of headache, vomiting, diplopia and gait disturbance. Continuous lumbar drainage was performed since lumbar puncture revealed surprisingly high cerebrospinal fluid (CSF) pressure and presence of many Cryptococcus neoformans, i.v. AMPH-B and p.o. 5-FC was also administrated. A 7 day course of i.v. AMPH-B and p.o. 5-FC showed no improvement with side effects of macrohematuria and anorexia. Then Miconazole was administrated i.v. and intrathecal (i.t.). The clinical signs and CSF laboratory data improved after a 90 day course of Miconazole therapy and the patient was discharged on August 24. But the patient was readmitted from March 10 to April 30, 1988, because of a slight increase of C. neoformans in CSF (17/mm3) and improved by i.v. and i.t. Miconazole. The total Miconazole dosage was 90.6 g (i.t.: 505 mg) at the first admission and 36 g (i.t.: 50 mg) at the second admission, but no side effect was seen. The reduction of elevated CSF pressure with continuous CSF drainage was also important for the treatment of such cases with increased intracranial pressure.
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PMID:[A case of cryptococcal meningitis successfully treated with miconazole and CSF drainage]. 261 99

A case of cryptococcal meningitis in a patient with the acquired immunodeficiency syndrome (AIDS) is described, as well as the epidemiology, pathogenesis, clinical manifestations, diagnosis, and therapeutic management of the disease. In July 1987 a 38-year-old white man was admitted to the hospital because of confusion, disorientation, and headache. His medical history was notable for a positive human immunodeficiency virus test. Culture of the cerebrospinal fluid was positive for Cryptococcus neoformans. The patient was started on amphotericin B 16 mg/day (0.3 mg/kg/day) intravenously and flucytosine 2 g every six hours (150 mg/kg/day) orally. Despite premedication with diphenhydramine and acetaminophen, he experienced rigors that were treated with hydrocortisone and meperidine. Three weeks later he was discharged on flucytosine 2 g orally every six hours and amphotericin B 50 mg intravenously every other day. One week later the patient developed fever and chills; blood cultures were positive for methicillin-sensitive Staphylococcus aureus, and his peripheral leucocyte count was 1.8 X 10(3)/cu mm. Flucytosine was discontinued, and he was treated with intravenous nafcillin while remaining on amphotericin B. In October the patient complained of nausea, vomiting, weakness, and agitation. A CSF latex agglutination titer for cryptococcal antigen was 1:32. He was treated with amphotericin B 50 mg daily until symptoms resolved and then continued on amphotericin B 50 mg twice weekly. Cryptococcosis is the most common life-threatening fungal infection among AIDS patients. In contrast to immunocompetent hosts, this population invariably develops disseminated disease, with 85% having meningeal involvement. The most effective therapy for cryptococcal meningitis in patients with AIDS has not been established.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of cryptococcal meningitis in patients with AIDS. 341 73

We report a 44-year-old Japanese man with chronic meningitis due to coccidoiodomycosis. He was admitted to our hospital because of pneumonia after the business trip to Phoenix, Arizona. Coccidioid immitis was cultured from periathric abscess on the sternoclavicular joint. He became asymptomatic by 5-FC administration. One year later, however, he complained of headache and fever. Coccidiodial meningitis was diagnosed by cerebrospinal fluid (CSF) examination. Both systemic and intrathecal administration of miconazole and oral itraconazole were ineffective. While meningitis was not cured for three years, normal pressure hydrocephalus (NPH) developed. CSF cell count fell into normal range after administration of fluconazole (800 mg/day) for thirteen months, but NPH continued. This is the first report of coccidiodimycosis with CNS involvement in Japan.
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PMID:[A case of coccidioidomycosis with central nervous system involvement]. 812 79

The authors studied the clinical histories of 17 patients with AIDS who were hospitalized with the diagnosis of Meningoencephalitis. Laboratory studies showed the causative agent to be Cryptococcus neoformans. All patients had fever and most had localized headache. Some patients had nausea and vomiting, nuchal rigidity and convulsions. One each had blurred vision, photophobia, periods of disorientation, ataxia, lumbar or cervical pain. Cell count, chemical analysis, India ink preparation and culture of the cerebrospinal fluid confirmed the diagnosis and the etiologic agent. Blood cultures were negative in the few patients on whom it was performed. The best results of therapy were obtained in the patients who received Amphotericin B and Fluocytosine (80%) in dosages of 0.3 to 1 mg/k/day and 150 mg/day respectively, for 21 days.
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PMID:[Cryptococcus neoformans meningitis in patients with AIDS at the Saint Thomas Hospital]. 896 38