产后急性视力丧失作为HIV相关隐球菌性脑膜炎的首发症状——一例罕见病例报告
Acute vision loss in post-partum period as presenting symptom of HIV-associated cryptococcal meningitis-an unusual case report.
作者信息
More Aniruddha, Garg Ravindra Kumar, Malhotra Hardeep Singh, Kumar Neeraj, Uniyal Ravi
机构信息
Department of Neurology, King George Medical University, Lucknow, PIN-226003, Uttar Pradesh, India.
出版信息
BMC Infect Dis. 2016 Oct 19;16(1):582. doi: 10.1186/s12879-016-1925-0.
BACKGROUND
Acute vision loss in the post-partum period can occur due to many reasons. Eclampsia, posterior reversible encephalopathy syndrome (PRES), pituitary apoplexy, and central serous retinopathy are some of the important causes. Cryptococcal meningitis as a cause of acute vision loss in the post-partum period has not been mentioned in literature.
CASE PRESENTATION
A 25-year-old female presented to us with acute bilateral complete vision loss in the post-partum period. Her serum was tested positive for HIV antibodies. Cerebrospinal fluid (CSF) examination revealed cryptococcal meningitis. She was started on amphotericin B, antiretroviral drugs, and steroids. Though symptoms of meningitis resolved after treatment no significant improvement in vision was observed at 3 months.
CONCLUSIONS
Cryptococcal meningitis may be considered as one of the causes of acute vision loss in pregnant/post-partum females with human immunodeficiency virus (HIV) positivity.
背景
产后急性视力丧失可能由多种原因引起。子痫、后部可逆性脑病综合征（PRES）、垂体卒中及中心性浆液性视网膜病变是一些重要病因。产后急性视力丧失的病因中，隐球菌性脑膜炎在文献中尚未被提及。
病例报告
一名25岁女性产后出现急性双侧完全性视力丧失前来就诊。其血清HIV抗体检测呈阳性。脑脊液（CSF）检查显示为隐球菌性脑膜炎。给予其两性霉素B、抗逆转录病毒药物及类固醇治疗。虽然治疗后脑膜炎症状消失，但3个月时视力未观察到明显改善。
结论
对于妊娠/产后HIV阳性女性，隐球菌性脑膜炎可被视为急性视力丧失的病因之一。
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