Treatment of Cryptococcal Meningitis in AIDS

Excerpt

To the Editors: In their recent article, Larsen and colleagues (1) report that patients with AIDS who had acute cryptococcal meningitis responded more frequently to reatment with amphotericin B and flucytosine than to treatment with fluconazole. We believe, however, that further amplification of several points is necessary to determine the feasibility of such combination therapy in these patients and to better show the contribution of flucytosine.

First, we are uncertain as to how frequently flucytosine dosing was interrupted because of the development of flucytosine toxicity; although the incidence of hepatitis, diarrhea, anemia, and thrombocytopenia is well described, there is no