Daly J S, Porter K A, Chong F K, Robillard R J
Department of Medicine, St. Elizabeth's Hospital, Boston, Massachusetts.
Am J Gastroenterol. 1990 Oct;85(10):1421-4.
Gastrointestinal cryptococcosis is extremely rare, especially in patients with no involvement of the central nervous system. We describe a 63-yr-old man undergoing prednisone therapy for chronic hepatitis and cirrhosis who presented with peritonitis, colitis, and skin lesions. Pathological studies revealed necrosis and numerous cryptococcal organisms in the colon, omentum, and skin, and cultures yielded Cryptococcus neoformans. The patient died of multisystem organ failure following emergency exploratory surgery performed when he had onset of symptoms of a bowel perforation after an endoscopic biopsy. Clinicians should be aware that gastrointestinal cryptococcosis can occur in the absence of infection of the central nervous system or lungs, and that it may affect relatively healthy patients who are immunocompromised because of splenectomy, chronic liver disease, or steroid therapy.
胃肠道隐球菌病极为罕见，尤其是在中枢神经系统未受累的患者中。我们报告一例63岁男性，因慢性肝炎和肝硬化正在接受泼尼松治疗，出现了腹膜炎、结肠炎和皮肤病变。病理研究显示结肠、大网膜和皮肤有坏死及大量隐球菌，培养结果为新型隐球菌。该患者在内镜活检后出现肠穿孔症状时接受了急诊探查手术，术后死于多系统器官衰竭。临床医生应意识到，胃肠道隐球菌病可在中枢神经系统或肺部无感染的情况下发生，且可能影响因脾切除术、慢性肝病或类固醇治疗而免疫功能低下的相对健康患者。
