Kushawaha Anurag, Mobarakai Neville, Parikh Nirupama, Beylinson Alex
Department of Medicine, Staten Island University Hospital, Staten Island (NYC), USA.
Cases J. 2009 Nov 19;2:209. doi: 10.1186/1757-1626-2-209.
Uncontrolled diabetics are prone to infections due to numerous factors as the glucose-rich blood serves as an excellent media for growth. Cryptococcus neoformans is an opportunistic fungus that is an important cause of CNS infections among immunocompromised patients, but it has only sporadically been reported in non-HIV-positive persons. The presence of elevated pro-inflammatory cytokines and abnormalities in numerous systemic indicators of inflammation in diabetics makes it conceivable that diabetics mount an exaggerated immune response to C. neoformans (paradoxical to their defective immune state) leading to grave outcomes. We present a fatal case of C. neoformans meningitis in a diabetic patient which emphasizes the perils of an overzealous immune response.
由于多种因素，血糖控制不佳的糖尿病患者易发生感染，因为富含葡萄糖的血液是微生物生长的良好培养基。新型隐球菌是一种机会性真菌，是免疫功能低下患者中枢神经系统感染的重要原因，但在非HIV阳性人群中仅有零星报道。糖尿病患者体内促炎细胞因子升高以及许多全身炎症指标异常，使得糖尿病患者可能对新型隐球菌产生过度的免疫反应（与其免疫功能缺陷状态相悖），从而导致严重后果。我们报告一例糖尿病患者发生新型隐球菌性脑膜炎致死的病例，该病例强调了过度免疫反应的危险性。
