Seffah Kofi, Agyeman Walter, Madeo Jennifer L, Ahmad Ayesha
Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.
Infectious Disease, Piedmont Athens Regional Medical Center, Athens, USA.
Cureus. 2022 Aug 3;14(8):e27635. doi: 10.7759/cureus.27635. eCollection 2022 Aug.
Cryptococcal meningitis is a fungal infection of the CNS, generally thought of as an opportunistic infection in those with T-cell immunodeficiencies including AIDS (usually with a CD4 count of less than 100), chronic steroid use, hematological malignancies, and transplant recipients. It can have irreversible CNS morbidity, including vision loss, intracranial hypertension, and cognitive decline. Diagnosis depends on cerebrospinal fluid (CSF) analysis, in which cultures and cryptococcal antigen are most sensitive. CSF PCR can also be done. Most patients have disseminated disease, and blood cultures are also positive. Outcomes remain guarded, with a poor prognosis (morbidity and high mortality) among survivors. This article presents a case of cryptococcal meningitis in an immunocompetent individual, where absolutely no identifiable risk factor was present.
隐球菌性脑膜炎是中枢神经系统的真菌感染，通常被认为是T细胞免疫缺陷患者（包括艾滋病患者，通常CD4细胞计数低于100）、长期使用类固醇、血液系统恶性肿瘤患者以及移植受者的机会性感染。它可导致不可逆的中枢神经系统病变，包括视力丧失、颅内高压和认知功能减退。诊断依赖于脑脊液（CSF）分析，其中培养和隐球菌抗原检测最为敏感。也可进行脑脊液聚合酶链反应（PCR）检测。大多数患者有播散性疾病，血培养也呈阳性。预后仍然不容乐观，幸存者预后较差（发病率高且死亡率高）。本文介绍了一例免疫功能正常个体发生隐球菌性脑膜炎的病例，该个体不存在任何可识别的危险因素。
