Hutchinson D O, Anderson N E, Ingram R J, Thomas M G, Ellis-Pegler R B, Bremner D A, Parr D H
Department of Neurology, Auckland Hospital.
N Z Med J. 1991 Feb 27;104(906):57-9.
Twenty-six patients with cryptococcal meningitis were seen in Auckland between 1969 and 1989. The incidence of cryptococcal meningitis in Auckland residents was 0.12 cases/100,000/year. Ten (38%) of the patients were Maori or Pacific Island Polynesians. Nineteen (73%) had a predisposing cause, including immunosuppressive therapy in nine and the acquired immunodeficiency syndrome (AIDS) in seven. The most common presenting syndrome was a subacute or chronic meningitis. Other clinical syndromes included a slowly progressive ataxia, polyradiculopathy, and headache with vomiting. In two patients, the symptoms of meningitis were overshadowed by those of systemic cryptococcal infection. Delay in making the diagnosis was common. The most sensitive method for diagnosing cryptococcal meningitis was the cerebrospinal fluid cryptococcal antigen test. Antifungal therapy cured 17 of the 25 (68%) treated patients overall, 15 of the 19 (79%) without AIDS and six of the seven with no underlying disease.
1969年至1989年期间，奥克兰有26例隐球菌性脑膜炎患者。奥克兰居民中隐球菌性脑膜炎的发病率为0.12例/10万/年。其中10例（38%）患者为毛利人或太平洋岛波利尼西亚人。19例（73%）有易感因素，包括9例接受免疫抑制治疗，7例患有获得性免疫缺陷综合征（艾滋病）。最常见的临床表现为亚急性或慢性脑膜炎。其他临床综合征包括缓慢进展的共济失调、多发性神经根病以及伴有呕吐的头痛。在2例患者中，脑膜炎症状被全身性隐球菌感染症状所掩盖。诊断延迟很常见。诊断隐球菌性脑膜炎最敏感的方法是脑脊液隐球菌抗原检测。抗真菌治疗使25例接受治疗的患者中的17例（68%）痊愈，其中19例非艾滋病患者中的15例（79%）以及7例无基础疾病患者中的6例痊愈。
