Offiah Curtis E, Naseer Aisha
Department of Neuroradiology, Imaging Department, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London E1 1BB, UK.
Department of Neuroradiology, Imaging Department, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London E1 1BB, UK.
Clin Radiol. 2016 Jan;71(1):9-17. doi: 10.1016/j.crad.2015.10.005. Epub 2015 Nov 10.
Cryptococcus neoformans infection is the most common fungal infection of the central nervous system (CNS) in advanced human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) patients, but remains a relatively uncommon CNS infection in both the immunocompromised and immunocompetent patient population, rendering it a somewhat elusive and frequently overlooked diagnosis. The morbidity and mortality associated with CNS cryptococcal infection can be significantly reduced by early recognition of the imaging appearances by the radiologist in order to focus and expedite clinical management and treatment. The emergence and evolution of anti-retroviral therapy have also impacted significantly on the imaging appearances, morbidity, and mortality of this neuro-infection. The constellation of varied imaging appearances associated with cryptococcal CNS infection in the HIV and AIDS population in the era of highly active anti-retroviral therapy (HAART) will be presented in this review.
新型隐球菌感染是晚期人类免疫缺陷病毒(HIV)和获得性免疫缺陷综合征(AIDS)患者中最常见的中枢神经系统(CNS)真菌感染,但在免疫功能低下和免疫功能正常的患者群体中仍然是一种相对不常见的CNS感染,这使得它成为一种有点难以捉摸且经常被忽视的诊断。放射科医生早期识别影像学表现,以便集中精力并加快临床管理和治疗,可以显著降低与CNS隐球菌感染相关的发病率和死亡率。抗逆转录病毒疗法的出现和发展也对这种神经感染的影像学表现、发病率和死亡率产生了重大影响。本综述将介绍在高效抗逆转录病毒疗法(HAART)时代,HIV和AIDS人群中与隐球菌CNS感染相关的各种影像学表现。