What is the treatment for Histoplasma capsulatum (H capsulatum) meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
  • Print
Answer

The recommended treatment for H capsulatum meningitis is liposomal amphotericin B (5 mg/kg/day IV for a total of 175 mg/kg given over 4-6 weeks), followed by oral itraconazole (200-300 mg 2 or 3 times daily for at least 1 year or until the resolution of CSF abnormalities and Histoplasma antigen levels). Blood levels of itraconazole should be measured to ensure good absorption of the oral drug.

This infection is associated with a poor outcome. Approximately 20-40% of patients with meningitis succumb to the infection despite amphotericin B therapy, and 50% of responders relapse after treatment is discontinued.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!