Berlin L, Pincus J H
Department of Neurology, Yale University School of Medicine, New Haven, Conn.
Arch Neurol. 1989 Dec;46(12):1312-6. doi: 10.1001/archneur.1989.00520480054020.
All cases of cryptococcal meningitis at Yale-New Haven (Conn) Hospital seen during a 4 1/2-year period were reviewed to calculate the rate of false-negative antigen test results and cultures preceding diagnosis. Of 13 patients, 9 were immunosuppressed and were diagnosed following the initial lumbar puncture, with both antigen test results and cultures positive in all cases. Among 4 nonimmunosuppressed patients, the rate of false-negative antigen test results was 77%, and of cultures, 89%. The diagnosis was consequently delayed in 3, 2 of whom died despite treatment. Cryptococcal meningitis may be underdiagnosed and undertreated to a significant degree in nonimmunosuppressed patients.
对耶鲁-纽黑文（康涅狄格州）医院在4年半时间内收治的所有隐球菌性脑膜炎病例进行了回顾，以计算诊断前抗原检测结果和培养结果假阴性的发生率。13例患者中，9例为免疫抑制患者，在首次腰椎穿刺后确诊，所有病例的抗原检测结果和培养结果均为阳性。在4例非免疫抑制患者中，抗原检测结果假阴性率为77%，培养结果假阴性率为89%。因此，3例患者的诊断被延迟，其中2例尽管接受了治疗仍死亡。在非免疫抑制患者中，隐球菌性脑膜炎可能在很大程度上未得到充分诊断和治疗。
