Amburgy John W, Miller Joseph H, Ditty Benjamin J, Vande Lune Patrick, Muhammad Shaaf, Fisher Winfield S
Department of Neurosurgery, University of Alabama at Birmingham, School of Medicine, Birmingham, AL, USA.
School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Case Rep Infect Dis. 2016;2016:8280915. doi: 10.1155/2016/8280915. Epub 2016 Nov 27.
Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is . In the Northwestern United States, has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to . The patient underwent 12 lumbar punctures and a ventriculoperitoneal shunt and required 83 days of inpatient therapy with 5-flucytosine and amphotericin B. The patient was found to have multiple intracranial lesions and a large intramedullary spinal cryptococcoma within his conus. Following an almost 3-month hospitalization the patient required treatment with oral voriconazole for one year. In the United States meningitis caused by infection is not isolated to the Northwestern region.
隐球菌感染在美国免疫功能低下和免疫功能正常的患者中均有发现。最常见的形式是……在美国西北部，由于毒力增加导致显著的发病率和死亡率，……受到了相当多的关注。现有文献中没有描述阿拉巴马州有患者因……需要神经外科干预的病例。一名中年免疫功能正常的男性，近期无旅行史或可识别的接触史，因……继发脑膜炎就诊。该患者接受了12次腰椎穿刺和一次脑室腹腔分流术，并需要使用5-氟胞嘧啶和两性霉素B进行83天的住院治疗。患者被发现有多个颅内病变以及圆锥内一个巨大的髓内脊髓隐球菌瘤。经过近3个月的住院治疗后，患者需要口服伏立康唑治疗一年。在美国，由……感染引起的脑膜炎并不局限于西北部地区。
