Fahad Fadi, Roddy Kristina, El-Hajjar Mohammad, Schulman-Marcus Joshua
Cardiology, Albany Medical College, Albany, New York, USA.
BMJ Case Rep. 2019 May 8;12(5):e226990. doi: 10.1136/bcr-2018-226990.
Acute neurological events are a common cause of ECG abnormalities and transient elevations in cardiac biomarkers. This case describes an uncommon presentation of cryptococcal meningitis in a non-immunosuppressed patient, presenting with altered sensorium and derangements in cardiac profile. Delay in diagnosing meningitis was avoided by paying close attention to the patient's presenting symptoms and by pursuing non-cardiac causes of ECG changes and elevations in cardiac troponin. Expeditious treatment and involvement of the infectious disease consultant resulted in excellent clinical response without permanent neurological sequelae.
急性神经事件是心电图异常和心脏生物标志物短暂升高的常见原因。本病例描述了一名非免疫抑制患者罕见的新型隐球菌性脑膜炎表现,伴有意识改变和心脏指标紊乱。通过密切关注患者的症状表现以及追查心电图变化和心肌肌钙蛋白升高的非心脏原因,避免了脑膜炎诊断的延误。迅速的治疗以及感染病会诊医生的参与带来了良好的临床反应,且未留下永久性神经后遗症。