[The usefulness of fluconazole administration and beta-D-glucan measurement in neurosurgical patients with deep-seated mycosis].
The diagnostic usefulness of beta-D-glucan values and the efficacy of flconazole (FLCZ) were investigated in 20 patients with deep-seated mycosis treated in our neurosurgical department from Oct 1, 1997 to May 31, 1998. The diagnosis of deep-seated mycosis was carried out using mycological and serological methods. When the serological beta-D-glucan value was above 10 pg/ml, the patient was considered to have deep-seated mycosis. In 13 patients (65%), the definite diagnosis of deep-seated mycosis was established by culture. In 7 patients, diagnosis based on serological examination alone was false positive or false negative. FLCZ 200 or 400 mg per day was administered for 10 days. Three patients were administered 200 mg/day FLCZ for another 10 days. No side effect of FLCZ was noticed among these patients. Three of 13 patients (23%) in whom fungi were isolated became fungi negative after FLCZ administration. The mean beta-D-glucan values before and after the administration of FLCZ were 36.37 mg/ml and 13.75 mg/ml, respectively. The beta-D-glucan values before and after the administration of FLCZ were significantly correlated with statistics (Student's t-test; p < 0.001). It was concluded that FLCZ was useful, and that beta-D-glucan values generally reflected the therapeutic effect of FLCZ. In contrast to the mycological culture tests that provided only a low detection rate, beta-D-glucan values were useful not only as a diagnostic means but also as a means to evaluate the efficacy of FLCZ treatment.