Gudesblatt M, Gerber O, Vaillancourt P D, Bronster D
Rev Neurol (Paris). 1987;143(4):290-3.
We report eight patients with cryptococcal meningitis and a cerebrospinal fluid characterized by few or no white blood cells and chemistries that may be near normal. In four of these patients, only testing for cryptococcal antigen allowed the initial diagnosis. Seven of the patients had a certain diagnosis of AIDS. Six have died. Autopsies performed in two cases indicated a poor meningeal inflammatory response. Contrary to the findings in most immunodeficient patients, in AIDS cryptococcal meningitis may present with few cellular or biochemical abnormalities in the cerebrospinal fluid. In AIDS patients presenting with headache and fever or change in mental status, examination of the cerebrospinal fluid should not be limited to routine studies.
我们报告了8例隐球菌性脑膜炎患者，其脑脊液的特点是白细胞很少或没有，且化学指标可能接近正常。在其中4例患者中，仅通过检测隐球菌抗原才得以初步诊断。这些患者中有7例被确诊患有艾滋病。6例已经死亡。对2例患者进行的尸检显示脑膜炎症反应较差。与大多数免疫缺陷患者的发现相反，在艾滋病患者中，隐球菌性脑膜炎可能在脑脊液中表现出很少的细胞或生化异常。对于出现头痛、发热或精神状态改变的艾滋病患者，脑脊液检查不应局限于常规检查。
