[一名看似免疫功能正常患者的隐球菌性脑膜脑炎]
[Cryptococcal meningo-encephalitis in an apparently immunocompetent patient].
作者信息
Bretaudeau K, Eloy O, Richer A, Bruneel F, Scott-Algara D, Lortholary O, Pico F
机构信息
Service de Neurologie, CH de Versailles, Hôpital A. Mignot, Le Chesnay.
出版信息
Rev Neurol (Paris). 2006 Feb;162(2):233-7. doi: 10.1016/s0035-3787(06)75005-6.
INTRODUCTION
Cryptococcal meningo-encephalitis is a rare disease occurring more frequently in immunocompromised hosts.
CASE REPORT
We report the case of an apparently immunocompetent patient who developed a recurrent neurological deficit with lymphocytic meningitis. The time from the first symptoms to diagnosis was 8 months. We noted mild CD4+ lymphocytopenia (500 cells/mm3) without HIV infection. CD4+ lymphocytes were not reactive for a panel of antigens.
CONCLUSION
This case illustrates the usefulness of cerebrospinal fluid Cryptococcus Neoformans antigen test in patients with an unexplained neurological syndrome with a lymphocytic meningitis together with quantification of circulating lymphocytes clusters and analyse of their function in opportunistic infections.
引言
隐球菌性脑膜脑炎是一种罕见疾病，在免疫功能低下的宿主中更常发生。
病例报告
我们报告了一例表面免疫功能正常的患者，该患者出现复发性神经功能缺损并伴有淋巴细胞性脑膜炎。从首次出现症状到确诊的时间为8个月。我们注意到患者有轻度CD4 +淋巴细胞减少（500个细胞/mm³），且未感染HIV。CD4 +淋巴细胞对一组抗原无反应。
结论
该病例说明了脑脊液新型隐球菌抗原检测在患有原因不明的伴有淋巴细胞性脑膜炎的神经综合征患者中的有用性，同时也说明了循环淋巴细胞群定量及分析其在机会性感染中的功能的重要性。
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