Becerra-Pedraza Luis Cuitláhuac, Martínez-Piña Daniel Arturo, Calles-Carmona Génesis Rocío, San-Juan Daniel
Clínica de Enfermedad Cerebro Vascular; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México; México.
Departamento de Neurofisiología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México; México.
Gac Med Mex. 2017;153(7):911-914. doi: 10.24875/GMM.17002676.
A 14-year-old female, presenting sudden and progressive holocraneal headache along with incoercible vomiting arrived to emergency room. Acute confusional state and meningoencephalitis syndrome where identified. Brain computed tomography-scan with normal results was performed. Lumbar puncture with crystal-clear cerebrospinal fluid was obtained: low glucose, elevated proteins and cell-count of 15/mm. China-Ink and Criptococcus neoformans culture both positive. Viral, lupus-anticoagulant, and HIV tests negative. Fluconazole 200 mg/kg/day, amphotericin-B 0.7 mg/kg/day, dexamethasone 1 mg/kg/day were prescribed. 48-h later evolved to cerebral edema, multiple-organ-failure and death. Hereby we present a Cryptococcus spp. infection case report, addressing the public health challenge and vulnerability of immunocompromised patients in Mexico.
一名14岁女性因突发进行性全颅头痛伴无法控制的呕吐被送至急诊室。诊断为急性意识模糊状态和脑膜脑炎综合征。脑部计算机断层扫描结果正常。腰椎穿刺获取的脑脊液清澈：葡萄糖含量低，蛋白质含量升高，细胞计数为15/mm。墨汁染色和新型隐球菌培养均呈阳性。病毒、狼疮抗凝物和HIV检测均为阴性。给予氟康唑200mg/kg/天、两性霉素B 0.7mg/kg/天、地塞米松1mg/kg/天。48小时后发展为脑水肿、多器官功能衰竭并死亡。在此，我们报告一例隐球菌属感染病例，以应对墨西哥免疫功能低下患者面临的公共卫生挑战和脆弱性。
