A Study of Fluconazole in the Treatment of Cryptococcal Meningitis in Patients Who Have Not Had Success With Amphotericin B

Inclusion Criteria Concurrent Medication: Allowed: * Immunosuppressant therapy. * Antiviral therapy such as zidovudine. * Prophylaxis for Pneumocystis carinii pneumonia. * Aerosolized pentamidine. Concurrent Treatment: Allowed: * Radiation therapy for mucocutaneous Kaposi's sarcoma. Not previously treated for acute cryptococcal meningitis and not eligible for Pfizer Central Research, protocol #159. * Patients must have a baseline cerebrospinal fluid (CSF) culture-positive for Cryptococcus neoformans. * Written informed consent must be obtained for each patient, either from the patient himself or from the patient's legal guardian. * Each individual patient must be approved by Pfizer Central Research prior to study entry. Prior Medication: Allowed: * Immunosuppressant therapy. * Antiviral therapy such as zidovudine. * Prophylaxis for Pneumocystis carinii pneumonia. * Aerosolized pentamidine. Exclusion Criteria Co-existing Condition: Patients with the following are excluded: * Evidence of acute or chronic meningitis based upon any etiology other than cryptococcosis. * History of allergy to or intolerance of imidazoles or azoles. * Moderate or severe liver disease. Concurrent Treatment: Excluded: * Lymphocyte replacement. Patients with the following are excluded: * Evidence of acute or chronic meningitis based upon any etiology other than cryptococcosis. * History of allergy to or intolerance of imidazoles or azoles. * Moderate or severe liver disease. * Satisfactory response to amphotericin B and have received a total amphotericin B dose of 15 mg/kg or more since CSF culture documentation of the current episode of acute cryptococcal meningitis. * Life expectancy of \< 2 weeks. Prior Medication: Excluded: * Coumadin-type anticoagulants. * Oral hypoglycemics. * Barbiturates. * Phenytoin. * Immunostimulants. * Investigational drugs or approved (licensed) drugs for investigational indications. Prior Treatment: Excluded: * Lymphocyte replacement.