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一名肝硬化HIV阴性患者发生播散性隐球菌病伴脑膜炎、腹膜炎和隐球菌血症:病例报告

Disseminated cryptococcosis with meningitis, peritonitis, and cryptococcemia in a HIV-negative patient with cirrhosis: a case report.

作者信息

Yehia Baligh Ramzi, Eberlein Michael, Sisson Stephen D, Hager David N

机构信息

Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 9020, Baltimore, Maryland, USA.

出版信息

Cases J. 2009 Oct 28;2:170. doi: 10.1186/1757-1626-2-170.

Abstract

INTRODUCTION

Cryptococcus neoformans is an encapsulated yeast that causes serious infections in immunocompromised populations. The majority of cases occur in HIV-infected individuals. Disseminated disease is uncommon, and very rarely includes peritonitis.

CASE PRESENTATION

We report a case of a 41-year-old, HIV-negative, Caucasian man with alcoholic liver cirrhosis who presented with fever and seizure. Disseminated cryptococcosis with meningitis, peritonitis, and cryptococcemia was diagnosed, and despite adequate treatment the patient developed multi-system organ failure and eventually expired.

CONCLUSION

Disseminated cryptococcosis, particularly with peritonitis, is an uncommon manifestation of Cryptococcus neoformans infection. Liver cirrhosis serves as a risk factor for disseminated disease in HIV-negative patients. A high clinical suspicion and early initiation of therapy is needed to recognize and treat patients effectively.

摘要

引言

新型隐球菌是一种有荚膜的酵母菌,可在免疫功能低下人群中引起严重感染。大多数病例发生在艾滋病毒感染者中。播散性疾病并不常见,腹膜炎则极为罕见。

病例报告

我们报告一例41岁、艾滋病毒阴性的白种男性,患有酒精性肝硬化,表现为发热和癫痫发作。诊断为播散性隐球菌病合并脑膜炎、腹膜炎和隐球菌血症,尽管给予了充分治疗,患者仍出现多系统器官衰竭并最终死亡。

结论

播散性隐球菌病,尤其是合并腹膜炎,是新型隐球菌感染的罕见表现。肝硬化是艾滋病毒阴性患者发生播散性疾病的危险因素。需要高度的临床怀疑并尽早开始治疗,以有效识别和治疗患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b58/2783126/6b605d57a954/1757-1626-2-170-1.jpg

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