Home » Volumes » Volume 25 Octuber/December 1992 » Estudo retrospectivo terapêutico da neurocriptococose em 112 aidéticos ou não

Estudo retrospectivo terapêutico da neurocriptococose em 112 aidéticos ou não

Evanil Pires de Campos; Valquíria Oliveira Carvalho; Sonia Fontes Marinho; Tuba Milstein Kushnaroff; Paulo Augusto Ayrosa Galvão; Carlos Roberto Padovani

DOI: 10.1590/S0037-86821992000400005


RESUMO

Cento e doze aidéticos ou não com neurocriptococose, admitidos no Hospital Emílio Ribas – São Paulo, Brasil, receberam anfotericina B (AMB) – grupo III ou a associação AMB/ 5 fluorcitosina (5FC): grupos I e II. Testes de Goodman aplicados revelaram: 1. leuco e glicorraquia semelhantes nos três grupos eproteinorraquia inferior a 85mg/dlapós 1, 5g/AMB; 1. a coloração pelo método da tinta da China e a cultura para Cryptococcus neoformans, positivas até l,Og/AMB; 3. hipocalemia na monoterapia, hipo e hipercalemia durante a associação; 4. as reações adversas mais evidentes a > 0,7gAMB/250g 5FC; 5. óbitos (precoce e tardio) frequentes no grupo 1 e nos grupos I e III entre 2,5 a 4,0g de AMB; 6. remissão e morte semelhantes nos grupos. A associação terapêutica iniciale amanutençãopelo AMB conduziram à recaída tardia

Palavras-chave: Neurocriptococose. Aidéticos e não. Terapia.


ABSTRACT

A total of 112 AIDS and no AIDS cryptococcosis patients admitted at Emílio Ribas Hospital – São Paulo, Brazil, were treated with amphotericin B (AMB) or amphotericin B and 5 fluorcytosine (5FC). Age, race, predisposing and epidemiological factors, respiratory symptons were evaluated. Goodman tests applied in three patients groups (I, II and III) with associate or unique therapy revealed: 1. prognostic factors: leukocytes ang glucose showed similar response in groups I, II and 111 and protein spinal fluid after l.Sg/AMB; 2. India ink tests and Cryptococcus culture were often positive until l.Og/AMB; 3. significant hypokalemia during monotherapy. Hypo and hyperkalemia had similar data in associate therapy; 4. significant difference in adverse reactions often appeared above 0.7g AMB/250g 5FC; 5. early and late death were common in group 111 (unique) and group I (no AIDS) and III (2.5 to 4. Og) respectively; 6. similar remission and deaths were verified in AIDS/ cryptococosis. Conclusions: adverse reactions were observed above 0.75g/AMBplus 250g 5FC. Association was important in initial therapy and AMB maintenance permitted late relapses.

Keywords: Neurocryptococcosis. AIDS and no AIDS. Therapy.


 

 

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 Endereço para correspondência:
Prof. Evanil Pires de Campos.
Rua João Miguel Rafael 350
18602-220
Botucatu, SP, Brasil

 

 

Recebido para publicação em 16/03/92.

 

 

Trabalho do Hospital Emílio Ribas, São Paulo e Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP.