Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Immunol. 2022 Feb 23;13:823021. doi: 10.3389/fimmu.2022.823021. eCollection 2022.
We report a previously healthy 82-year-old male with cryptococcal meningitis (CM) who represented neurological deterioration due to post-infectious inflammatory response syndrome (PIIRS) occurring in 4 months after initial antifungal therapy. He was treated with corticosteroids for 2 months and recovered clinically. However, the clinical manifestation, cerebrospinal fluid (CSF), and brain magnetic resonance imaging (MRI) results got worse again on the next day after corticosteroid withdrawal. The analysis of inflammatory cytokines and culture on CSF, as well as brain MRI, still suggested a diagnosis of PIIRS. Therefore, corticosteroid therapy was used again and he subsequently obtained a complete resolution of symptoms.
我们报告了一例先前健康的 82 岁男性，他患有隐球菌性脑膜炎 (CM)，在初始抗真菌治疗后 4 个月因感染后炎症反应综合征 (PIIRS) 而出现神经功能恶化。他接受了 2 个月的皮质类固醇治疗，临床症状得到了恢复。然而，在停用皮质类固醇的第二天，临床症状、脑脊液 (CSF) 和脑磁共振成像 (MRI) 结果再次恶化。对炎症细胞因子的分析以及 CSF 培养和脑 MRI 仍提示 PIIRS 的诊断。因此，再次使用皮质类固醇治疗，随后他的症状完全缓解。
