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一名免疫功能正常男性的腰椎播散性隐球菌感染

Disseminated Cryptococcal Infection of the Lumbar Spine in an Immunocompetent Man.

作者信息

Wang Rui, Luo Huating, Xin Xiaojuan, Qin Bo, Huang Wenxiang

机构信息

Department of Infectious Diseases, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Department of Geriatrics, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.

出版信息

Infect Drug Resist. 2022 Aug 4;15:4229-4234. doi: 10.2147/IDR.S359612. eCollection 2022.

Abstract

infection mainly occurs in immunocompromised hosts, especially those with AIDS, and skeletal infection is a rare presentation of cryptococcosis. We report a rare case of disseminated cryptococcal infection of the lumbar spine in an immunocompetent man caused by . The lesion position first appeared on upper right lung and then spread to the fourth lumbar vertebra. The result of periodic acid-Schiff (PAS) and Gomori's methenamine silver (GMS) staining of the tissue sample matched cryptococcal infection, but multiple culture was negative. Eventually, was confirmed using next-generation sequencing (NGS). Current follow-up of 12 months indicated a stable condition after antifungal therapy (fluconazole 400 mg/day) combined with surgery. Our case reminds that physicians must consider the possibility of skeletal cryptococcosis in patients with bone lesions, and NGS might be an excellent option to obtain the most accurate diagnosis in clinical practice.

摘要

感染主要发生在免疫功能低下的宿主中,尤其是艾滋病患者,而骨骼感染是隐球菌病的罕见表现。我们报告了一例免疫功能正常男性因……导致腰椎播散性隐球菌感染的罕见病例。病变部位最初出现在右上肺,然后蔓延至第四腰椎。组织样本的过碘酸-希夫(PAS)染色和戈莫里甲胺银(GMS)染色结果符合隐球菌感染,但多次培养均为阴性。最终,通过下一代测序(NGS)得以确诊。目前12个月的随访表明,抗真菌治疗(氟康唑400毫克/天)联合手术后病情稳定。我们的病例提醒医生,对于有骨病变的患者必须考虑骨骼隐球菌病的可能性,而NGS可能是临床实践中获得最准确诊断的极佳选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5581/9359805/9fca2c4af5fb/IDR-15-4229-g0001.jpg

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