A 35-year-old man from Zambia who is HIV-positive with a CD4 count of 80 cells/µL presents with chronic headache and neck stiffness. CSF India ink sho...

Question

A 35-year-old man from Zambia who is HIV-positive with a CD4 count of 80 cells/µL presents with chronic headache and neck stiffness. CSF India ink shows encapsulated yeasts. CSF opening pressure is 38 cmH₂O. What is the most important therapeutic intervention to reduce intracranial pressure?

Accepted Answer

Therapeutic lumbar puncture - drain enough CSF to reduce opening pressure to ≤20 cmH₂O, repeated daily as needed

Answer

Intravenous mannitol

Answer

Intravenous dexamethasone

Answer

Surgical ventriculoperitoneal shunt

Answer

Acetazolamide

uk-dtmh MCQ (SBA): Cryptococcal ICP Management

A 35-year-old man from Zambia who is HIV-positive with a CD4 count of 80 cells/µL presents with chronic headache and neck stiffness. CSF India ink shows encapsulated yeasts. CSF opening pressure is 38 cmH₂O. What is the most important therapeutic intervention to reduce intracranial pressure?