Department of Emergency Medicine, Vanderbilt University Medical Center, 1313 21st Ave, South, 703 Oxford House, Nashville, TN 37232-4700, United States of America.
Department of Emergency Medicine, Vanderbilt University Medical Center, 1313 21st Ave, South, 703 Oxford House, Nashville, TN 37232-4700, United States of America.
Am J Emerg Med. 2020 Nov;38(11):2492.e1-2492.e3. doi: 10.1016/j.ajem.2020.05.115. Epub 2020 Jun 6.
Cryptococcal meningitis is a fungal infection that is most commonly thought of as an opportunistic infection affecting immunocompromised patients, classically patients with Human Immunodeficiency (HIV) infection. It is associated with a variety of complications including disseminated disease as well as neurologic complications including intracranial hypertension, cerebral infarcts, vision loss and other neurologic deficits. It is diagnosed by lumbar puncture with CSF studies, including fungal culture and cryptococcal antigen testing. We present a case of cryptococcal meningitis and fungemia in a previously healthy male patient who presented after multiple emergency department visits with persistent headache. After multiple visits, he underwent a lumbar puncture consistent with cryptococcal infection, and he was admitted to the hospital for initiation of antifungal therapy. His workup revealed no known underlying condition leading to immune compromise.
隐球菌性脑膜炎是一种真菌感染,通常被认为是一种机会性感染,影响免疫功能低下的患者,经典的是人类免疫缺陷病毒 (HIV) 感染的患者。它与多种并发症相关,包括播散性疾病以及神经并发症,包括颅内高压、脑梗死、视力丧失和其他神经功能缺损。它通过腰椎穿刺和脑脊液研究诊断,包括真菌培养和隐球菌抗原检测。我们报告了一例以前健康的男性患者的隐球菌性脑膜炎和菌血症,该患者在多次急诊科就诊后持续头痛。经过多次就诊,他进行了腰椎穿刺,符合隐球菌感染,随后他被收治入院接受抗真菌治疗。他的检查结果没有发现导致免疫功能低下的已知潜在疾病。