Because of the severity of some of the infections, such as the risk of meningitis with Coccidioides exposure, strong consideration should be given to antifungal prophylaxis for those at heightened ...risk. Meningitis (Cryptococcus) Ketoconazole (ND; Histoplasma); amphotericin B (ND), fluconazole (ND; Cryptococcus) Lobectomy for Histoplasma-related bronchiectasis Cr1 18/M/A R423Q (DNA binding) Cryptococcus gattii C gattii C gattii meningitis Liposomal amphotericin B, flucytosine, voriconazole Papilledema and increased opening pressures without vision changes Cr2E7 29/F/B ND Cryptococcus neoformans N Colon, perirectal abscess Amphotericin B (10 wk) and 5-flucytosine (ND) ND Cr3E8 31/M/W ND C neoformans N Esophageal Amphotericin B (6 wk) and 5-flucytosine (6 wk) ND Cr4E9 13/M/ND ND C neoformans N Meningitis Amphotericin B (10 wk), 5-flucytosine (6 wk), dexamethasone (12 wk), fluconazole (6 mo) Myeloperitoneal shunt Co1 4/F/W V713M (transactivation) Coccidioides immitis Y Meningitis Liposomal amphotericin, fluconazole Stroke, hydrocephalus, bilateral VP shunt, hypercalcemia Co2E10 17/F/ND T412S (DNA binding) C immitis Y Meningitis, cerebral abscess Amphotericin B (3 wk), fluconazole (lifelong) Altered mental status requiring temporary intubation Co3E11 4/F/ND ND Cimmitis N Meningitis Amphotericin B (ND), fluconazole (ND) Strokes Table E1 Cases and literature review of patients with HIES with endemic fungal infections A, Asian; B, black; N, no; ND, not documented; W, white; Y, yes.
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