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Which of the following drugs would be an appropriate treatment for this patient?
A 31-year-old homosexual male with AIDS presents to the emergency room with fever (102.3 F°), headache, confusion, muddled thinking, and vomiting. Physical examination reveals nuchal rigidity, diplopia, and loss of vision. An agglutination test of the spinal fluid for capsular polysaccharide antigen is positive.



A. Ampicillin and erythromycin
B. Saquinavir and foscarnet
C. Pyrimethamine and sulfadiazine
D. Amphotericin B and flucytosine
E. Tolnaftate and nystatin
F. Terbinafine and griseofulvin

This question is part of block 15 pharm antifungal drugs

Asked by Hammet, Last updated: Sep 08, 2020

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1 Answer

John Smith

John Smith

John Smith
John Smith

Answered Sep 09, 2016

Amphotericin b and flucytosine-answer: d the history, symptoms an signs of the patient strongly suggest the diagnosis of cryptococcal meningitis. in fact after toxoplasmosis, cryptococcosis is the most common cns infection associated with aids. cryptococcus neoformans is a yeast that is characterized by a thick polysaccharide capsule. during infection the capsular polysaccharide is solubilized in spinal fluid and can be detected by an agglutination test which is diagnostic of cryptococcosis. cryptococcus neoformans is sensitive to amphotericin b, flucytosine and antifungal azoles. the current treatment recommended for acute cryptococcal meningitis is amphotericin b plus flucytosine. synergism between the two drugs has been demonstrated in vitro and in vivo. it may be related to enhanced penetration of flucytosine through the amphotericin-damaged fungal cell membrane. a, b, c) these agents are not antifungal drugs. e, t) these antifungal drugs are not effective against cryptococcus neoformans.
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