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Thirty-seven of 47(79%;95%,CI,61%to 90%)available patients responded to treatment.Response rates were similar for patients with and without previous therapy,for patients with and without concomitant HIV infection, and for patients with and without preexisting hydrocephalus.Most improvement occurred within 4 to 8 months after starting treatment.Patient symptoms resolved more quickly than did cerebrospinal fluid abnormalities. In 15 of 20 responding patients followed for 20 months or more,residual low level cerebrospinal fluid abnormalities remained throughout therapy.No patient discontinued therapy because of drug-related side effects,although confusion developed in two patients that resolved when the dose of fluconazole was reduced.Fluconazole therapy is often effective in suppressing coccidioidal meningitis. |
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