A 28-year-old immunocompromised man with CD4 count of 45 cells/μL presents with severe frontal headache, fever, and neck stiffness. Lumbar puncture shows elevated protein (180 mg/dL), low glucose (35 mg/dL), and negative bacterial cultures. India ink stain of CSF shows encapsulated yeasts. Which of the following antifungal agents is most appropriate for initial therapy?
- A)Griseofulvin
- B)Caspofungin
- C)Amphotericin BGABARITO
- D)Fluconazole alone
- E)Terbinafine
Explicação
Cryptococcus neoformans meningitis in severely immunocompromised patient (CD4 <50) requires amphotericin B as induction therapy. India ink stain showing encapsulated yeast is pathognomonic. Amphotericin B achieves adequate CNS penetration and is bactericidal. Ver explicação completa e trilha adaptativa →