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暴发性脑膜炎:艾滋病患者中单纯疱疹病毒 2 型和隐球菌合并感染的罕见病例。

Fulminant Meningitis: A Rare Case of HSV-2 and Cryptococcal Co-Infection in a Patient With AIDS.

机构信息

St. Joseph's University Medical Center, Paterson, NJ, USA.

St. George's University, Grenada, West Indies.

出版信息

J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241286380. doi: 10.1177/23247096241286380.

Abstract

Cryptococcal meningitis (CM) is a severe and often fatal infection of the central nervous system that is caused by spp. Cryptococcal meningitis mainly affects immunocompromised individuals such as those with AIDS, organ transplantation recipients, and those with conditions requiring prolonged immunosuppressive therapy. Infection typically begins with the inhalation of cryptococcal spores, often from bird droppings, which can remain dormant in the lungs and lymph nodes before disseminating to the central nervous system. Signs and symptoms include headache, nausea, and cognitive impairment, which can progress to severe neurological complications if not promptly treated. Even in the era of antifungal and antiretroviral therapies, CM remains a public health challenge with substantial morbidity and mortality. Although rare, sporadic cases of coinfection with , and have been reported in the literature. Herein, we describe an extremely rare case of fulminant meningitis due to herpes simplex virus (HSV)-2 and coinfection. Our patient also had cryptococcemia, which is known to increase acute mortality rates in patients with CM.

摘要

隐球菌性脑膜炎(CM)是一种严重且常致命的中枢神经系统感染,由 spp 引起。CM 主要影响免疫功能低下的个体,如艾滋病患者、器官移植受者以及需要长期免疫抑制治疗的患者。感染通常始于吸入隐球菌孢子,这些孢子通常来自鸟类粪便,在传播到中枢神经系统之前,可以在肺部和淋巴结中潜伏。症状包括头痛、恶心和认知障碍,如果不及时治疗,可能会进展为严重的神经并发症。即使在抗真菌和抗逆转录病毒治疗时代,CM 仍然是一个具有重大发病率和死亡率的公共卫生挑战。尽管罕见,但文献中已有报道 与 、 合并感染的散发性病例。在此,我们描述了一例由单纯疱疹病毒(HSV)-2 和 合并感染引起的暴发性脑膜炎的极罕见病例。我们的患者还伴有隐球菌血症,这已知会增加 CM 患者的急性死亡率。

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