Cryoptococcal meningitis

January 2007     View PDF     En español

Is treatment or prevention different for women?

At this time, there are no known differences in the way that women respond to therapy or in significant side effects to treatment. For pregnant women, however, treatment with any of the azole drugs including fluconazole (Diflucan), itraconazole (Sporonox) and ketoconazole (Nizoral) may cause severe birth defects. Amphotericin B alone until clearance of Cryptococcus is seen in the spinal fluid (2–4 weeks) is recommended as primary therapy for women who become ill with cryptococcal meningitis while pregnant.

Because of the high rate of relapse mentioned above, pregnant women who are successfully treated for Cryptococcus should be monitored closely for a reoccurrence of the infection. Also, because of the success of anti-HIV treatment in controlling other types of opportunistic infections, pregnant women who become ill with cryptococcal meningitis may want to strongly consider anti-HIV therapy. Lastly, if you were treated for cryptococcal meningitis during pregnancy, you should discuss the option of beginning maintenance therapy with fluconazole after giving birth to your child.