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一例艾滋病相关隐球菌性脑膜炎伴多发颅神经病变。

A case of AIDS associated cryptococcal meningitis with multiple cranial nerve neuropathies.

作者信息

Mohan Sumit, Ahmed Saud I, Alao Oladipo A, Schliep Tjark C

机构信息

Department of Internal Medicine, Division of Infectious Diseases, Columbia University at Harlem Hospital, New York, NY 10037, USA.

出版信息

Clin Neurol Neurosurg. 2006 Sep;108(6):610-3. doi: 10.1016/j.clineuro.2006.01.005. Epub 2006 Feb 17.

Abstract

Cryptococcal meningitis is a common opportunistic infection among patients with AIDS. Cranial nerve neuropathies are well-known complications that occur due to increased intracranial pressure and inflammation of cranial nerves in such patients but have not been previously reported to involve more than four cranial nerves simultaneously. Our patient had involvement of five cranial nerves resulting in the complete loss of vision and hearing as well palsies of the third, sixth and seventh cranial nerves. He was treated with multiple antifungal medications. Repeated high volume lumbar punctures and Ommaya reservoir were used to lower intracranial pressure. At the time of discharge the patient had complete recovery of the functions of third, sixth and seventh cranial nerves bilaterally and partial recovery of hearing and vision.

摘要

隐球菌性脑膜炎是艾滋病患者中常见的机会性感染。颅神经病变是这类患者因颅内压升高和颅神经炎症而出现的众所周知的并发症,但此前尚未有同时累及超过四条颅神经的报道。我们的患者有五条颅神经受累,导致视力和听力完全丧失,以及第三、第六和第七颅神经麻痹。他接受了多种抗真菌药物治疗。反复进行大容量腰椎穿刺和使用奥马亚贮液器来降低颅内压。出院时,患者双侧第三、第六和第七颅神经功能完全恢复,听力和视力部分恢复。

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