Abstract
Non-HIV Cryptococcal Meningitis (CM) is often complicated by a post-infectious inflammatory response syndrome (PIIRS), characterized by neurologic deterioration in previously-healthy patients with CM after appropriate antifungal therapy and conversion of CSF fungal cultures to negative. PIIRS is due to an appropriate inflammatory response to fungal antigen released during therapy, mediated by IFN-gamma and IL-6 stimulating T-helper cells, leading to immune-mediated host damage. At the National Institutes of Health (NIH), patients with non-HIV CM-related PIIRS have been successfully treated with methylprednisolone burst and slow prednisone taper.
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