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

✍ Scribed by R.Andrew Seaton; Nitin Verma; Sirus Naraqi; Jacob P. Wembri; David A. Warrell

Book ID: 104164705
Publisher: Elsevier Science
Year: 1997
Tongue: English
Weight: 401 KB
Volume: 91
Category: Article
ISSN: 0035-9203
DOI: 10.1016/s0035-9203(97)90393-x

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✦ Synopsis

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 loo-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 (2116 [12.5%] vs. 7/10 [70%], P=O.O07), blindness was less frequent (1116 [5.3%] vs. 5/10 [50%], P=O.O18), 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.

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