Acharya Roshan, Khanal Kishor, Upadhyaya Prabhaw, Kafle Smita, Savaliya Vipul
Department of Medicine, Cape Fear Valley Hospital, Fayetteville, NC 28304, USA.
Department of Anesthesia and Critical Care Medicine, Nepal Mediciti Hospital, Kathmandu, Nepal.
IDCases. 2020 Oct 24;22:e00988. doi: 10.1016/j.idcr.2020.e00988. eCollection 2020.
Cryptococcal meningoencephalitis (CM) is one of the major causes of mortality and morbidity in immunocompromised patients estimating 650,000 deaths each year. Across the globe, CM has been occasionally seen in apparently immunocompetent patients who otherwise don't have established risk factors. The clinical presentation of CM in immunocompetent hosts is subtle and often results in complications including persistent neurological deficits and death. We present a case of Cryptococcal neoformans meningitis in a diabetic female with no other identified risk factors. Although her clinical presentation was atypical, her clinical course was uncomplicated. The pathophysiology in immunocompetent hosts appears somewhat different, so is the clinical presentation. Since there are no separate evidence-based treatment recommendations, it is challenging to treat this group of patients. There seems to be a need for further studies for management in CM for HIV negative, non-transplant immunocompetent patients.
隐球菌性脑膜脑炎（CM）是免疫功能低下患者死亡和发病的主要原因之一，估计每年有65万人死亡。在全球范围内，CM偶尔也会出现在表面免疫功能正常但无既定危险因素的患者中。免疫功能正常宿主中的CM临床表现不明显，常导致包括持续性神经功能缺损和死亡在内的并发症。我们报告一例无其他明确危险因素的糖尿病女性新型隐球菌脑膜炎病例。尽管其临床表现不典型，但其临床过程并无并发症。免疫功能正常宿主中的病理生理学似乎有所不同，临床表现也是如此。由于没有单独的循证治疗建议，治疗这组患者具有挑战性。对于HIV阴性、非移植免疫功能正常患者的CM管理，似乎需要进一步研究。
