PMC9681777_01
The medication of the patient during admission to our hospital. The patient first received induction therapy with L-AMB (10-30 mg/d) and fluconazole (400-800 mg/d), then followed by adding 5-flucytosine (25 mg/kg, 6-hourly) and intermittent use of Dexamethasone (1-5 mg/d).
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F1
Dexamethasone (1-5 mg/d) was also used to alleviate inflammation-induced edema intermittently (Figure 1). Then, she was switched to consolidation therapeutic schedule shifting from L-AMB to fluconazole (400 mg orally, BID) and 5-flucytosine (25 mg/kg 6-hourly) (Figure 1).
The brain MRI images of the patient. During the episode, the brain MRI showed hypointense signal in T1-weighted imaging and hyperintensity in T2-weighted imaging in the bilateral deep white matter and the corpus callosum. And there was an obviously bilaterally symmetric hyperintense DWI signal in the same region (A). MRI after 4 days showed improvement of the abnormal signal in white matter, the hypointense ADC signal in the same region (B). After 1 month, the images of her brain were almost normal (C).
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F2
T2 weight image in the deep white matter and corpus callosum (Figure 2). The abnormal signals gradually reduced and disappeared 4 days later. A month after the encephalopathy, her brain MRI was almost normal (Figure 2).