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Nephrotoxicity is exacerbated by use of concomitant nephrotoxic medicine. Permanent nephrotoxicity is related to cumulative dose. Nephrotoxicity will be ameliorated by hydration before amphotericin B infusion. Amphotericin B deoxycholate, at 1 mg/kg/day, is best tolerated by children than it is by adults, is efficient, and could also be used when price of the lipid preparations is a consideration. Other much less pricey or higher tolerated lipid formulations may be substituted for the liposomal product. The dosage of liposomal amphotericin B for youngsters is 3--5 mg/kg/day. Amphotericin B deoxycolate undergoes renal excretion as inactive drug. Additionally, given the low incidence of cryptococcosis in HIV-contaminated kids, lack of survival benefits in major prevention studies of adults (349), chance of drug interaction, potential resistance to antifungal medicine, and price, routine use of antifungal medications isn't really useful for major prophylaxis of cryptococcal infections in youngsters (DIII). Because the incidence of cryptococcal illness is so low in HIV-infected children (4,339--341), routine testing of asymptomatic children for serum cryptococcal antigen is not really helpful (DIII). Diffuse pulmonary disease can be diagnosed by bronchoalveolar lavage and direct examination of India ink-stained specimens, culture, and antigen detection. In some instances (e.g., refractory or relapsed disease), susceptibility testing of the C. neoformans isolate might be useful. Check out my page - frecams

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