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[艾滋病患者的隐球菌病:1996年至2006年在帕罗西安医院的病例研究]

[Cryptococcosis in AIDS patients: case study from 1996 to 2006 in Paroissien Hospital].

作者信息

Mónaco L S, Tamayo Antabak N

机构信息

Laboratorio Central, Sección Microbiología, Hospital Interzonal General de Agudos Dr. Diego Paroissien, Av. Brig. Gral. D. J. M. de Rosas 5475, (1765) I. Casanova, La Matanza, Buenos Aires, Argentina.

出版信息

Rev Argent Microbiol. 2008 Oct-Dec;40(4):218-21.

Abstract

Clinic, epidemiological and microbiological characteristics of 128 episodes of cryptococcosis were retrospectively evaluated in 106 positive HIV patients hospitalized at the Paroissien Hospital on period 1996-2007. There were 75 male and 31 female patients, with a median age of 34 years, ranging from 20 to 68 years. Addiction to intravenous drugs was the main cause of HIV infection in 55 patients (51.9%). Cryptococcosis was detected as single episode in 85 patients (80.2%) and as relapse in 19 (17.9%). It appeared as the first marking disease in 36 patients (34.0%). Diagnosis was established in 116 episodes by CSF study (Indian ink, culture, antigen detection), in 9 cases by Cryptococcus sp. recovery from blood cultures, and in 3 cases by antigen detection in patient's serum with a latex reactive. Neurological symptomatology, with headache and fever as the most common signs, was presented by 89.6% of patients. Induction treatment was done in all cases with amphotericin B, and maintenance treatment was carried out with fluconazole. Mortality rate was 35.8%, being higher in those patients who had suffered relapses (41.3%) compared to those who presented a first episode of the mycosis (33.3%).

摘要

对1996年至2007年期间在帕罗西恩医院住院的106例HIV阳性患者中发生的128例隐球菌病病例的临床、流行病学和微生物学特征进行了回顾性评估。患者中男性75例,女性31例,中位年龄为34岁,年龄范围在20至68岁之间。55例患者(51.9%)的HIV感染主要原因是静脉药物成瘾。85例患者(80.2%)的隐球菌病表现为单发,19例(17.9%)为复发。36例患者(34.0%)的隐球菌病为首发标志性疾病。116例病例通过脑脊液检查(墨汁负染、培养、抗原检测)确诊,9例通过血培养分离出隐球菌确诊,3例通过乳胶凝集试验检测患者血清中的抗原确诊。89.6%的患者出现神经症状,最常见的症状是头痛和发热。所有病例均采用两性霉素B进行诱导治疗,并用氟康唑进行维持治疗。死亡率为35.8%,复发患者的死亡率(41.3%)高于首次发生真菌病的患者(33.3%)。

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