All issues > Volume 21(4); 1978

Case Report

J Korean Pediatr Soc. 1978;21(4):305-311. Published online April 30, 1978.

A Case of Cryptococcosis treated with 5-Fluorocytosine.

K S Han, J Y Kim, E J Lee, D J Yun

¹Department of Pediatrics Yonsei University College of Medicine Seoul, Korea.

Abstract

Cyptococcosis, also known as Torulosis or European Blastomycosis is a mycotic disease caused by encapsulated budding, yeast-like organism Cryptococcus Neoformans (Torula histolytica or Cryptococcus hominis) with a special prediliction for the central nervous system. Lung, bone, skin, liver, spleen and lymph nodes are also involved. The prognosis of Cryptococcosis, especially Cryptococcal meningitis was always grave until the advent of Amphotericin B. The mortality rates were markedly decreased by Amphotericin B. But it has severe side effects with low dosages and renal function imparirment and has to be administered only intravenously. Recently a new antifungal agent, 5-Fluorocytosine was introduced. It can be given by oral route and has few side effects. We have experienced a case of Cryptococcosis treated with 5-Fluorocytosine and Amphotericin B, both. A parient with the chief complaints of dyspnea for 10 days and growing masses on the face for 2 months was aadmitted and confirmed as Cryptococcosis by biopsies of skin, liver and inguinal lymph nodes. With the examination of spinal fluid, the CNS was also involved. At first, 5-Fluorocytosine was administered. But the resistence to 5-Fluorocytosine appeared after aout 60 days(150-200mg/kg/day). So, Amphotericin B was used with 5-Fluorocytosine without serious side effects. He was discharged with the slight improvement and treated continuously as the outparient.

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