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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.

Type

Journal article

Journal

Trans R Soc Trop Med Hyg

Publication Date

01/1997

Volume

91

Pages

50 - 52

Keywords

Adolescent, Adult, Amphotericin B, Anti-Inflammatory Agents, Antifungal Agents, Blindness, Child, Cryptococcosis, Dexamethasone, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Hydrocortisone, Male, Meningitis, Fungal, Prednisolone, Pseudotumor Cerebri, Retrospective Studies, Vision Disorders