Sandbox fungal meningitis

Meningitis Main Page
Patient Information
Overview
Causes
Classification Viral Meningitis Bacterial Meningitis Fungal Meningitis
Differential Diagnosis
Diagnosis
Treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;Sheng Shi, M.D. [2]

fungal meningitis

Blastomyces

Blastomyces Preferred Regimen ▸ Liposomal amphotericin B 5 mg/kg/day IV for 4–6 weeks Followed By ▸ Fluconazole 800 mg/day PO OR ▸ Itraconazole 200 mg PO bid or tid OR ▸ Voriconazole 200–400 mg IV q12h

Candidiasis

Candidiasis Preferred Regimen ▸ lipid-based ampho B 3–5 mg/kg/day PLUS OR NOT ▸ 5-Fluorocytosine 25 mg/kg PO qid Alternative Regimen ▸ Fluconazole 400–800 mg (6–12 mg/kg) IV or PO

Histoplasma

Histoplasma Preferred Regimen ▸ Liposomal ampho B 5 mg/kg/d, for a total of 175 mg/kg over 4-6 wk Followed By ▸ Itraconazole 200 mg/day PO bid or tid for at least 12 month

Coccidioides

Coccidioides Preferred Regimen ▸ FLuconazole 400 mg/day PO OR ▸ Itraconazole 400–600 mg/day PO

Cryptococcus HIV/AIDS

Cryptococcus, HIV/AIDS Induction Phrase(for 2 wks) ▸ Amphotericin B deoxycholate 0.7 mg/kg/day IV PLUS ▸ 5-Fluorocytosine 100 mg/kg/day PO Consolidation phase(for 8 wks) ▸ Fluconazole 400 mg/day PO OR ▸ Itraconazole 400 mg/day PO Maintenance phase ▸ Fluconazole 200 mg/day PO

Cryptococcus Immunocompetent

Cryptococcus, Immunocompetent Induction Phrase(for 2 wks) ▸ Amphotericin B 0.7-1 mg/kg/day IV OR ▸ Liposomal amphotericin B 5 mg/kg/day PO PLUS ▸ 5-Fluorocytosine 25 mg/kg PO q6h Consolidation phase(for 8 wks) ▸ Fluconazole 400 mg/day PO qd Maintenance phase(for 12 mo) ▸ Fluconazole 200 mg PO qd

Viral Meningitis

Herpes simplex Meningitis Preferred Regimen ▸ Aciclovir IV OR ▸ Valaciclovir PO

Parasitic Meningitis

Angiostrongyliasis

Angiostrongyliasis Preferred Regimen ▸ albendazole 60 kg or greater： 400 mg twice daily PO with meals OR less than 60 kg:7.5 mg/kg PO bid with meals (maximum total daily dose 800 mg)

Amebic meningoencephalitis

Amebic meningoencephalitis Preferred Regimen ▸ Miltefosine

Eosinophilic myeloencephalitis, Meningitis

Eosinophilic myeloencephalitis, Meningitis Preferred Regimen ▸ albendazole

Toxoplasma gondii, Meningitis

Toxoplasma gondii, Meningitis Preferred Regimen ▸ albendazole

M. tuberculosis Meningitis Adapted from Treatment of Tuberculosis guidelines

M. tuberculosis ▸ Rifampicin 8-12 mg/kg/day PO daily max: 600mg OR 8-12mg/kg/day PO 3 times per week x:600mg PLUS ▸ Isoniazid 4-6 mg/kg/day PO daily max: 300mg OR 8-12mg/kg/day PO 3 times per week daily max:900mg PLUS ▸ Pyrazinamide 20-30 mg/kg/day PO OR 30-40mg/kg/day PO 3 times per week PLUS ▸ Streptomycin 12-18 mg/kg/day IM OR 25-35mg/kg/day PO 3 times per week daily max:1000mg Continuation Phase ▸ Rifampicin 8-12 mg/kg/day PO daily max: 600mg OR 8-12mg/kg/day PO 3 times per week daily max:600mg PLUS ▸ Isoniazid 4-6 mg/kg/day PO daily max: 300mg OR 8-12mg/kg/day PO 3 times per week daily max:900mg