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[一名无严重免疫缺陷女孩患新型隐球菌新型变种所致致死性脑膜脑炎]

[Lethal meningeal encephalitis from Cryptococcus neoformans var. neoformans in a girl without serious immunodeficiency].

作者信息

Wendisch J, Blaschke-Hellmessen R, Kaulen F, Schwarze R, Kabus M

机构信息

Klinik und Poliklinik für Kinderheilkunde, Universitätsklinikums Carl Gustay Carus, Technischen Universität Dresden, BR Deutschland.

出版信息

Mycoses. 1996;39 Suppl 1:97-101. doi: 10.1111/j.1439-0507.1996.tb00513.x.

Abstract

Case report on a lethal meningo-encephalitis due to Cryptococcus neoformans in a 14-year-old girl without serious immunodeficiency inclusive HIV-infection. The detection of high quantities of cells of Cryptococcus neoformans (about 10,000/ml) and high levels of Cryptococcus antigen (up to 1:2048) in the cerebrospinal fluid are remarkable. The patient was treated with a triple combination of amphotericin B, flucytosine and fluconazole. After 18 days the cerebrospinal fluid was sterile. Nevertheless considerable lesions of the brain arised. The patient died from the Cryptococcus infection on day 74 of the antimycotic therapy. Cryptococcosis should be included into the differential diagnosis of the chronic lymphocytic pleocytosis of the cerebrospinal fluid connected with symptoms of intracranial pressure and ocular symptoms.

摘要

一名14岁无严重免疫缺陷(包括未感染HIV)的女孩因新型隐球菌感染导致致死性脑膜脑炎的病例报告。脑脊液中检测到大量新型隐球菌细胞(约10,000/ml)和高水平的隐球菌抗原(高达1:2048),这很显著。患者接受了两性霉素B、氟胞嘧啶和氟康唑的三联联合治疗。18天后脑脊液无菌。然而,脑部出现了相当严重的病变。患者在抗真菌治疗第74天死于隐球菌感染。隐球菌病应纳入与颅内压症状和眼部症状相关的脑脊液慢性淋巴细胞增多症的鉴别诊断中。

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