Schurter H R, Hedinger C
Institut für Pathologie der Universität Zürich.
Schweiz Med Wochenschr. 1987 Aug 4;117(31-32):1186-90.
The case is described of a 49-year-old man who developed cryptococcal meningo-encephalitis ten months before his death. Six months later complicating hydrocephalus occurred which required the implantation of a ventriculo-peritoneal shunt. A further four months later the patient, who was receiving anticoagulation therapy due to deep vein thrombosis, died from intraventricular cerebral haemorrhage. In a blood culture taken shortly before his death, growth of Cryptococcus neoformans was detected. At autopsy, which confirmed cerebral haemorrhage as the cause of death, a large cryptococcoma of the left adrenal gland was discovered as an incidental finding. We presume that this cryptococcoma was the source of the new haematogenous dissemination of the disease. We review the literature and discuss the increasing importance of cryptococcosis.
本文描述了一名49岁男性病例,该患者在去世前十个月患上隐球菌性脑膜脑炎。六个月后出现了并发脑积水,需要植入脑室-腹腔分流管。又过了四个月,因深静脉血栓正在接受抗凝治疗的患者死于脑室内出血。在其去世前不久采集的血培养中,检测到新型隐球菌生长。尸检证实脑出血为死因,同时意外发现左肾上腺有一个大的隐球菌瘤。我们推测这个隐球菌瘤是疾病新的血行播散来源。我们回顾了文献并讨论了隐球菌病日益增加的重要性。