The effect of corticosteroids on visual loss in Cryptococcus neoformans var. gattii meningitis.

Abstract

In Papua New Guinea visual loss is a frequent sequal to Cryptococcus neoformans var. gattii meningitis in immunocompetent patients. We have previously postulated that visual loss may occur as a result of the immunological response to infection around the optic nerve. This retrospective study set out to explore the effect of corticosteroids on visual outcome. Sixteen patients received varying doses of corticosteroid (mainly 100-250 mg of hydrocortisone daily for the prevention of febrile reactions to amphotericin) and 10 received anticryptococcal therapy alone. Visual deterioration occurred less frequently in those treated with corticosteroids (2/16 [12.5%] vs. 7/10 [70%], P = 0.007), blindness was less frequent (1/16 [5.3%] vs. 5/10 [50%], P = 0.018), and in 3 patients vision improved. Corticosteroids may have a role in preventing or halting visual loss in C. neoformans var. gattii meningitis in immunocompetent patients.

• Authors: R A Seaton, N Verma, S Naraqi, J P Wembri, D A Warrell
• Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) 1997 Jan-Feb Vol. 91 Issue 1 Pg. 50-2 ISSN: 0035-9203 [Print] England
• PMID: 9093628 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Antifungal Agents
• Dexamethasone
• Amphotericin B
• Prednisolone
• Hydrocortisone

Topics

• Adolescent
• Adult
• Amphotericin B (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Antifungal Agents (therapeutic use)
• Blindness (prevention & control)
• Child
• Cryptococcosis (complications, drug therapy)
• Dexamethasone (therapeutic use)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Humans
• Hydrocortisone (therapeutic use)
• Male
• Meningitis, Fungal (drug therapy)
• Prednisolone (therapeutic use)
• Pseudotumor Cerebri (complications, drug therapy)
• Retrospective Studies
• Vision Disorders (complications, prevention & control)