Dexamethasone in Cryptococcal Meningitis
Meningitis, Cryptococcal, HIV Infections
About this trial
This is an interventional treatment trial for Meningitis, Cryptococcal focused on measuring AIDS-Related Opportunistic Infections, Meningitis, Cryptococcosis, Dexamethasone, Drug Therapy, Combination, Fluconazole, Flucytosine, Acquired Immunodeficiency Syndrome, Amphotericin B, Brain Diseases
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: Aerosolized pentamidine or systemic chemoprophylaxis for PCP. Preventive therapy for steroid-associated ulcers and any other therapies required to manage steroid toxicity (e.g., insulin). Patients must have: Documented initial episode or relapse of acute cryptococcal meningitis. (NOTE: Patients must be untreated for this episode except for administration of a test dose of 1 g or less amphotericin B.) Acute cryptococcal meningitis with cerebrospinal fluid opening pressure >= 250 mm H2O prior to receipt of antifungal therapy for this episode. Documented HIV infection OR a diagnosis of AIDS based on a documented AIDS-defining opportunistic infection. Ability to begin therapy within 8 hours after the pre-entry lumbar puncture. Consent of parent or guardian if less than 18 years of age. NOTE: Comatose patients eligible provided informed consent can be provided by guardian or next of kin. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Concurrent CNS disease such as another infection or neoplasm that would interfere with assessment of response. Prison incarceration. Concurrent Medication: Excluded: Acetazolamide, mannitol, urea preparations, and other corticosteroids during the first 72 hours of the study. Treatment or prophylaxis with other systemic antifungal agents at any time. Antiretroviral therapy during the first 72 hours of the study. Prior Medication: Excluded within 7 days prior to study entry: Corticosteroids, mannitol, urea preparations, acetazolamide, or more than 24 hours of phenytoin.
Sites / Locations
- Univ of Alabama at Birmingham
- Georgetown Univ Med Ctr
- Univ of Miami School of Medicine
- Northwestern Univ Med School
- Cook County Hosp
- Bronx Municipal Hosp Ctr/Jacobi Med Ctr
- Jack Weiler Hosp / Bronx Municipal Hosp
- Bronx Veterans Administration / Mount Sinai Hosp
- SUNY / Health Sciences Ctr at Brooklyn
- SUNY / Erie County Med Ctr at Buffalo
- Beth Israel Med Ctr
- Mount Sinai Med Ctr
- Ohio State Univ Hosp Clinic
- Univ of Puerto Rico