结核性脑膜炎。人类免疫缺陷病毒感染患者的临床特征及与隐球菌性脑膜炎的比较。

Tuberculous meningitis. Clinical characteristics and comparison with cryptococcal meningitis in patients with human immunodeficiency virus infection.

作者信息

Sánchez-Portocarrero J, Pérez-Cecilia E, Jiménez-Escrig A, Martin-Rabadán P, Roca V, Ruiz Yague M, Romero-Vivas J, Palau E, Picazo J J

机构信息

Department of Neurology, Hospital Universitario San Carlos, Madrid, Spain.

出版信息

Arch Neurol. 1996 Jul;53(7):671-6. doi: 10.1001/archneur.1996.00550070109018.

DOI:10.1001/archneur.1996.00550070109018

PMID:8929175

Abstract

OBJECTIVE

To determine the prevalence and causes of meningitis in patients with human immunodeficiency virus (HIV) infection.

DESIGN

A prospective study of HIV-associated neurologic complications carried out from 1988 to 1992.

SETTING

A tertiary care university hospital in Madrid, Spain. PATIENTS. A total of 142 patients, 65% of whom were injecting drug users.

RESULTS

Thirty-six episodes of meningitis were diagnosed in 33 patients (23%). Of these, 17 cases (47%) were tuberculous meningitis (5 definite and 12 probable) and 7 (19%) corresponded to cryptococcal meningitis. Comparative studies of the tuberculous and cryptococcal meningitis cases showed injecting drug use as the most common form of HIV transmission in the tuberculous meningitis (P = .03) and a lower mean CD4+ cell count in the cryptococcal meningitis group (P = .02).

CONCLUSIONS

Tuberculous meningitis was the prime type of meningitis, which was associated with HIV transmission by injecting drug use. Cryptococcal meningitis appears in more advanced stages of HIV infection, which determines its characteristic presentation.

摘要

目的

确定人类免疫缺陷病毒（HIV）感染患者中脑膜炎的患病率及病因。

设计

1988年至1992年对HIV相关神经并发症进行的前瞻性研究。

地点

西班牙马德里的一家三级护理大学医院。患者：共142例患者，其中65%为注射吸毒者。

结果

33例患者（23%）诊断出36次脑膜炎发作。其中，17例（47%）为结核性脑膜炎（5例确诊，12例可能），7例（19%）为隐球菌性脑膜炎。结核性脑膜炎和隐球菌性脑膜炎病例的对比研究显示，注射吸毒是结核性脑膜炎中最常见的HIV传播形式（P = .03），隐球菌性脑膜炎组的平均CD4+细胞计数较低（P = .02）。