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秘鲁亚马逊地区一家医院内一名免疫功能低下患者的加氏隐球菌脑膜炎：病例报告

Cryptococcus gattii meningitis in an immunocompromised patient in a hospital in the Peruvian Amazon: case report.

作者信息

Moreno-Soto Angel A, Cardenas-Golac Rodrigo J, Paredes-Obando Marco F, Vasquez-Ascate Jhosephi J, Sibina-Vela Jorge, Ramírez-García Edgar A, Celis-Salinas Juan C, Casapia-Morales Wilfredo M

机构信息

Universidad Nacional de la Amazonía Peruana, Iquitos, Perú.

Hospital Regional de Loreto, Iquitos, Perú.

出版信息

Rev Peru Med Exp Salud Publica. 2025 Aug 25;42(2):212-216. doi: 10.17843/rpmesp.2025.422.14195.

DOI:10.17843/rpmesp.2025.422.14195
PMID:40900489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12377883/
Abstract

We report a case of Cryptococcus gattii meningitis in a patient with HIV in the Peruvian Amazon. A 36-year-old male patient with severe neurological symptoms that was diagnosed by cerebrospinal fluid culture. Although liposomal amphotericin B and flucytosine are considered the standard antifungal therapy, due to a lack of resources, an alternative treatment of amphotericin B deoxycholate and fluconazole was used. Even with this alternative, treatment faced challenges due to the persistence of the microorganism. This case highlights the importance of considering C. gattii in the differential diagnosis of cryptococcal meningitis in immunocompromised patients, even in areas where the prevalence of this pathogen is low. The effectiveness of treatment and the patient's survival underscore the need for diagnostic and therapeutic strategies adapted to resource-limited settings.

摘要

我们报告了秘鲁亚马逊地区一名感染艾滋病毒患者患加氏隐球菌脑膜炎的病例。一名36岁男性患者出现严重神经症状，通过脑脊液培养确诊。尽管脂质体两性霉素B和氟胞嘧啶被认为是标准的抗真菌治疗方法，但由于资源匮乏，采用了两性霉素B脱氧胆酸盐和氟康唑的替代治疗方法。即便采用了这种替代疗法，由于微生物持续存在，治疗仍面临挑战。该病例凸显了在免疫功能低下患者的隐球菌性脑膜炎鉴别诊断中考虑加氏隐球菌的重要性，即使在该病原体患病率较低的地区。治疗效果和患者的存活情况强调了需要有适应资源有限环境的诊断和治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/e7bf3fe44475/rpmesp-42-02-14195-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/fe51be16a707/rpmesp-42-02-14195-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/3850074f8628/rpmesp-42-02-14195-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/3beb6e83debf/rpmesp-42-02-14195-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/e7bf3fe44475/rpmesp-42-02-14195-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/fe51be16a707/rpmesp-42-02-14195-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/3850074f8628/rpmesp-42-02-14195-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/3beb6e83debf/rpmesp-42-02-14195-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aea/12377883/e7bf3fe44475/rpmesp-42-02-14195-g004.jpg

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Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM.全球隐球菌病诊断和管理指南：欧洲癌症研究与治疗组织和国际系统性真菌感染学会与美国微生物学会合作开展的一项倡议。
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Cryptococcus gattii infections.加氏隐球菌感染
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Fatal Cryptococcus gattii genotype AFLP5 infection in an immunocompetent Cuban patient.一名免疫功能正常的古巴患者发生致命的加氏隐球菌AFLP5基因型感染。
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