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November 1958

Cryptococcal Meningitis Treated with Amphotericin B

Author Affiliations

St. Louis

From the Department of Internal Medicine, St. Louis University School of Medicine, and the Medical Service of the St. Mary's Group of Hospitals of St. Louis University School of Medicine.

AMA Arch Intern Med. 1958;102(5):795-800. doi:10.1001/archinte.1958.00260220111011

Cryptococcosis, in common with many fungal diseases, remains a difficult problem due to the lack of an effective therapeutic agent.1-4 Reports of new antifungal drugs, notably nystatin and Actidione,3,5-8 have helped to stimulate interest in this disease. Amphotericin B, a recently isolated derivative of a streptomycete,9-11 has shown promise in the therapy of several fungal diseases, including cryptococcosis. Reports of clinical trials are few; Appelbaum and Shtokalko 12 illustrated the arrest of cryptococcal meningitis with Amphotericin B, though evaluation of therapy is difficult in a disease known for spontaneous remissions.1,2,13-15

The following case of cryptococcal meningitis treated with amphotericin B, but ending fatally in spite of clearing the spinal fluid of organisms, is presented to add to the clinical experience in the use of this drug.

Report of Case  A 32-year-old housewife was first admitted to St. Mary's Hospital on Oct. 8, 1956, for delivery of

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