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多器官播散性隐球菌病 1 例

A Case of Multiple Organ Disseminated Cryptococcosis.

机构信息

Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.

Division of Hospital Medicine, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI.

出版信息

R I Med J (2013). 2021 Jun 1;104(5):44-46.

Abstract

Cryptococcus neoformans is an encapsulated yeast found worldwide.1 Patients with immunosuppression, including individuals with HIV/AIDS, transplant recipients and/or individuals with other T-cell mediated immunosuppression are more susceptible to becoming infected with Cryptococcus neoformans than immunocompetent individuals.2 This is a case report of a 66-year-old woman who presented to the emergency department with an unsteady gait and urinary incontinence. Magnetic resonance imaging (MRI) on presentation showed a large C5-C6 central disc protrusion. The patient underwent surgical repair and was treated with five days of IV steroids. Later in the course of her hospitalization, she had an unexplained increasing leukocytosis and tachycardia with witnessed episodes of unresponsiveness. She subsequently had a pulseless electrical activity cardiac arrest and succumbed despite resuscitative efforts. A post-mortem diagnosis revealed Cryptococcus neoformans fungemia and disseminated cryptococcosis involving multiple organs. Disseminated cryptococcosis primarily affects the central nervous system3, and thus this report presents a rare case of disseminated cryptococcosis involving multiple organs.

摘要

新型隐球菌是一种在世界各地都能发现的有囊酵母。1 免疫抑制的患者,包括艾滋病毒/艾滋病患者、移植受者和/或其他 T 细胞介导的免疫抑制患者,比免疫功能正常的个体更容易感染新型隐球菌。2 这是一位 66 岁女性的病例报告,她因步态不稳和尿失禁到急诊科就诊。就诊时的磁共振成像(MRI)显示 C5-C6 颈椎中央椎间盘突出。患者接受了手术修复,并接受了五天的静脉类固醇治疗。在住院过程中,她出现了不明原因的白细胞增多和心动过速,并伴有意识丧失的目击发作。随后,她发生了无脉性电活动心搏骤停,尽管进行了复苏努力,但仍死亡。尸检诊断显示新型隐球菌菌血症和播散性隐球菌病累及多个器官。播散性隐球菌病主要影响中枢神经系统 3,因此本报告提出了一个罕见的累及多个器官的播散性隐球菌病病例。

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