Collins J V, Tong D, Bucknall R G, Warin A P
Postgrad Med J. 1972 Jan;48(555):52-5. doi: 10.1136/pgmj.48.555.52.
Cryptococcosis, a disease of world-wide distribution, is uncommon in the British Isles where it usually presents as meningitis affecting patients with malignant disease of the reticulo-endothelial system, diabetes mellitus or those receiving systemic treatment with corticosteroids. The clinical features and physical signs of the disease are often non-specific and resemble those of tuberculous meningitis. The diagnosis is made upon recognizing the encapsulated on Indian Ink preparations of the cerebrospinal fluid, or by demonstrating precipitating antibodies to the organism in the patient's serum. The treatment is by intravenous administration of amphotericin B for a period of 6-12 weeks, supplemented in severe or relapsing cases by intrathecal therapy; alternatively, 5-fluorocytosine may be given by mouth. A case is reported of cryptococcal meningitis occurring in a 46-year-old woman with systemic lupus erythematosus treated with methylprednisolone. Treatment with amphotericin B was successful in suppressing the infection, but was accompanied by side-effects and some temporary impairment of renal function.
隐球菌病是一种遍布全球的疾病，在不列颠群岛并不常见，在那里它通常表现为脑膜炎，影响患有网状内皮系统恶性疾病、糖尿病的患者或接受皮质类固醇全身治疗的患者。该疾病的临床特征和体征通常不具有特异性，与结核性脑膜炎相似。诊断是通过在脑脊液的墨汁涂片上识别出有荚膜的菌体，或通过检测患者血清中针对该病原体的沉淀抗体来进行的。治疗方法是静脉注射两性霉素B 6至12周，在严重或复发病例中辅以鞘内治疗；或者，可口服5-氟胞嘧啶。本文报告了一例46岁患有系统性红斑狼疮并接受甲泼尼龙治疗的女性发生隐球菌性脑膜炎的病例。两性霉素B治疗成功抑制了感染，但伴有副作用和一些肾功能的暂时损害。
