Ondounda M, Mounguengui D, Mandji Lawson J M, Magne C, Nziengui Madjinou M I C, Kombila U, Nzenze J R
Med Trop (Mars). 2010 Aug;70(4):406.
Neuromeningeal cryptococcosis occurs mainly in immunodepressed patients and especially AIDS patients. The purpose of this study was to determine the clinical and prognostic features of this severe brain infection.
This retrospective study was carried out on HIV-infected patients hospitalized for cryptococcal meningitis in the internal medicine unit of a military hospital in Libreville, Gabon from January 1, 2006 to November 31, 2009.
Eleven cases of cryptococcosis were identified among a total of 290 cases of AIDS. Mean patient age was 39 years. The main clinical manifestation was headache that was either isolated or associated with other cerebral signs. In all cases, cerebrospinal fluid analysis demonstrated a clear aseptic aspect with direct examination after addition of India ink showing the presence of encapsulated yeast cells identified as cryptococcus. The patient was treated with amphotericin B and fluconazole. The mortality rate was 81.8% (9/11 cases).
Since the manifestations of cryptococcosis during clinical AIDS are non-specific, systematic screening is recommended in AIDS patients. Early treatment could reduce mortality.
神经脑膜隐球菌病主要发生在免疫抑制患者，尤其是艾滋病患者中。本研究的目的是确定这种严重脑部感染的临床和预后特征。
本回顾性研究针对2006年1月1日至2009年11月31日期间在加蓬利伯维尔一家军队医院内科住院治疗隐球菌性脑膜炎的HIV感染患者进行。
在总共290例艾滋病病例中确诊了11例隐球菌病。患者平均年龄为39岁。主要临床表现为头痛，可为单独出现或伴有其他脑部症状。所有病例中，脑脊液分析显示无菌性表现，加入印度墨汁后的直接检查显示存在被鉴定为隐球菌的有荚膜酵母细胞。患者接受两性霉素B和氟康唑治疗。死亡率为81.8%（9/11例）。
由于临床艾滋病期间隐球菌病的表现不具特异性，建议对艾滋病患者进行系统筛查。早期治疗可降低死亡率。
