Tuesday, October 16, 2018

Repeated USMLE Questions Step 1- 234

A 22-year-old female with a history of acquired immunodeficiency syndrome (AIDS) develops low grade fever, headache and blurred vision. Cerebrospinal fluid (CSF) testing for Cryptococcal antigen is positive.

Which of these drugs can be given orally to treat Cryptococcal meningitis?

A- Amphotericin B

B- Caspofungin

C- Fluconazole

D- Metronidazole


This is a tricky question. The ideal regimen for treating cryptococcal meningitis is IV amphotericin B followed by oral fluconazole. Caspofungin is one of the echinocandins which is used in candidiasis and is only available in IV preparations. Metronidazole is a distraction as it is not effective against Cryptococcus but it is indicated in cases of anaerobic bacterial infections.

The correct answer is C

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