Complicated and protracted cryptococcal disease in HIV-infected children.

We report 7 HIV-infected children with cryptococcosis. Median age and CD4 counts were 9.3 years and 12 cells/mm, respectively. Two children died early. Of 4 children requiring prolonged amphotericin B and fluconazole at a dosage above 12 mg/kg/d, 3 presented with meningitis and 1 with fever. Immune reconstitution inflammatory syndrome contributed to morbidity through exacerbations at the primary site and elsewhere.