Lalloo D, Fisher D, Naraqi S, Laurenson I, Temu P, Sinha A, Saweri A, Mavo B
Division of Medicine, Medical Faculty, University of Papua New Guinea.
Q J Med. 1994 Jun;87(6):343-9.
Cryptococcal meningitis is a common cause of chronic meningitis in Papua New Guinea, affecting apparently immunocompetent people. The majority of infections are believed to be due to Cryptococcus neoformans var. gattii. We have reviewed the records of 49 Melanesian adults who presented with proven cryptococcal meningitis to the University teaching hospital in Port Moresby, and compare our findings with other published studies of cryptococcal meningitis in the tropics and sub-tropics. None of the patients had an obvious cause of immunosuppression. Visual disturbances and fundoscopic changes of papilloedema or papillitis were particularly common. The in-hospital case fatality rate for patients treated with amphotericin B and flucytosine was 22.4%. Of the fully treated patients, 31% became completely blind before being discharged from hospital. Therapy directly aimed at reducing intracranial pressure may improve outcome.
隐球菌性脑膜炎是巴布亚新几内亚慢性脑膜炎的常见病因，可感染表面上免疫功能正常的人群。大多数感染被认为是由新型隐球菌格特变种所致。我们回顾了49名美拉尼西亚成年患者的病历，这些患者在莫尔斯比港的大学教学医院被确诊为隐球菌性脑膜炎，并将我们的研究结果与其他已发表的关于热带和亚热带地区隐球菌性脑膜炎的研究进行了比较。所有患者均无明显的免疫抑制病因。视觉障碍以及视乳头水肿或视乳头炎的眼底镜改变尤为常见。接受两性霉素B和氟胞嘧啶治疗的患者院内病死率为22.4%。在接受充分治疗的患者中，31%在出院前完全失明。直接针对降低颅内压的治疗可能会改善预后。
