Document 2659
 DOCN  M94A2659
 TI    Cryptococcosis in HIV infected children.
 DT    9412
 AU    Valada MG; Nunes C; Jacob CM; Del Negro G; Marques HH; Grumach AS;
       Aquino MZ; Dept. Pediatrics & Microbiology, Univ Sao Paulo, Brazil.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):254 (abstract no. PB0446). Unique
       Identifier : AIDSLINE ICA10/94369916
 AB    Cryptococcosis is an unnusual disease in children but its incidence is
       increasing since the advent of AIDS. The authors report four cases of
       Cryptococcosis in HIV infected children diagnosed between 1985 and 1994
       among 170 children followed in our servicein this period. The patients
       were 9 and 11 years old with blood products transmission, and 3 and 7
       years old in perinatally contamination. In one case, neurocryptococcosis
       had been the first manifestation of AIDS. All the children had
       neurological symptoms. The diagnosis was confirmed by CSF culture and in
       3 cases the Latex aglglutination test was positive with high titers
       bellow 1/500. After the beginning of the treatment, the serologic titers
       fell to 1/40 or less, despite of the cultures that remained positive for
       a prolonged period (45 days or more). The drug of choice to initiate the
       treatment was AmphoB. In one case 5FC was associated without response.
       The use of intrathecal AmphoB was performed with good results. Long term
       suppressive therapy was not instituted and relapsed occourred. The
       response to further treatment with AmphoB and 5FC was good. The second
       child died 4 days after the diagnosis. The other two children received
       AmphoB during 40 and 50 days respectively and it was discontinued due to
       intolerance and side effects. Fluconazole was initiated with good
       results and mainteined in the suppressive therapy. The authors emphasize
       the increasing importance of C. neoformans infection in children with
       AIDS and the need to be aware about the problems in the management and
       follow-up of these cases, especially the long time spent to the
       sterilization of CSF and the importance of long term suppresseve
       therapy.
 DE    Amphotericin B/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS  AIDS-Related
       Opportunistic Infections/*DIAGNOSIS/DRUG THERAPY/  MORTALITY  Brazil
       Child  Child, Preschool  Cryptococcosis/*DIAGNOSIS/DRUG
       THERAPY/MORTALITY  Dose-Response Relationship, Drug  Female
       Fluconazole/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS  Human  Male
       Survival Rate  MEETING ABSTRACT

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