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crypto with hiv

Apr 12, 2011

hi dr. Gowan, i aksed about my 8 year old nephew with cryptococus fungus and hiv+ and got ur answer so first of all thnx for ur reply. now i have recieved the results of his reports and m sending u the same so please tell me wats best in the situation? He is infected with CRYPTOCOCCUS FUNGUS in blood and brain LP test is done twice MRI (MAGNETIC RESONANCE IMAGING) is done that show fungus in brain there is some problem in lever and lumb ultrasound has done kidney stones are available in three sizes HIV test is positive CD4 counts are done CD4 counts are 053 only injection amphotericin b given in 10 mg,and tabelts flucytocine 500 mg. injection monocef 1g please tell ur opinion. thnx n rgds indy

Response from Dr. McGowan

Dear Indy,

It sounds as though your nephew is getting the right care. First step is to treat the infection and amphotericin B with flucytosine (5FC) is the standard treatment. It usually takes about 2 weeks of this intravenous treatment (perhaps longer if a repeat spinal tap still shows that the infection is active). This will be followed by pills (fluconazole) which he will stay on until his immune system recovers after his HIV is treated. Most people would wait between 2 to 8 weeks before starting medication for HIV when a person has cryptocossus around the brain. This will give time to get the fungal infection beaten down so that the body will not generate too much inflammation once the HIV meds start to build up his immune system.



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