CANDIDAL MENINGITIS IN HIV-INFECTED PATIENTS

Candida meningitis is considered a rare event in HIV-infected patients , and little is known about risk factors, clinical presentation, thera py of choice, or outcome in this population. In a review of 14 cases, we observed a low frequency of the disease, a strong association to ot her well-known risk factors for systemic candidiasis, such as intraven ous drug use, and a chronic course and clinical features that mimic th ose of cryptococcal or tuberculous meningitis. Although the role of fl uconazole treatment remains to be defined, the combination of amphoter icin B with flucytosine offers a survival rate similar to non-HIV-infe cted patients. In addition, the use of suppressive therapy with flucon azole for a prolonged period after clinical improvement seems recommen dable.