Imwidthaya P, Poungvarin N
Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Postgrad Med J. 2000 Feb;76(892):85-8. doi: 10.1136/pmj.76.892.85.
A total of 87 patients (17 female, 70 male) were admitted to SIRIRAJ HOSPITAL, MAHIDOL UNIVERSITY, BANGKOK, THAILAND, from JANUARY 1996 TO DECEMBER 1997, with a diagnosis of cryptococcal meningitis and underlying AIDS. The age range was 14: 70 years, mean 32.1. Six females (35%) and thirty-one males (44%) died, while the others were discharged home after clinical improvement. The mean duration of admission of those who died was 14.5 days, which was shorter than that of the patients who survived (25.7 days). Cerebral cryptococcosis was diagnosed using culture (100%), India ink preparation (91%), latex agglutination test (100%), and polymerase chain reaction (86%). Polymerase chain reaction fingerprinting of Cryptococcus neoformans revealed 99% serotype A and 1% serotype B. The mean minimum inhibitory concentrations of amphotericin B, flucytosine, fluconazole and itraconazole against 87 isolates of C neoformans were 0.55 microg/ml (0.25-1, SD = 0.22), 9.5 microg/ml (2-20, SD = 4.91), 6.9 microg/ml (1-16, SD = 4.42) and 0.36 microg/ml (0.125-1.0, SD = 0.23), respectively. These findings showed that the cryptococcal infections were sensitive to these antifungal agents.
1996年1月至1997年12月期间,共有87例患者(17例女性,70例男性)入住泰国曼谷玛希隆大学诗里拉吉医院,诊断为隐球菌性脑膜炎并伴有潜在的艾滋病。年龄范围为14至70岁,平均32.1岁。6名女性(35%)和31名男性(44%)死亡,其他患者在临床症状改善后出院回家。死亡患者的平均住院时间为14.5天,短于存活患者(25.7天)。采用培养法(100%)、印度墨汁涂片法(91%)、乳胶凝集试验(100%)和聚合酶链反应(86%)诊断脑隐球菌病。新型隐球菌的聚合酶链反应指纹图谱显示99%为A型血清型,1%为B型血清型。两性霉素B、氟胞嘧啶、氟康唑和伊曲康唑对87株新型隐球菌的平均最低抑菌浓度分别为0.55微克/毫升(0.25 - 1,标准差 = 0.22)、9.5微克/毫升(2 - 20,标准差 = 4.91)、6.9微克/毫升(1 - 16,标准差 = 4.42)和0.36微克/毫升(0.125 - 1.0,标准差 = 0.23)。这些结果表明隐球菌感染对这些抗真菌药物敏感。