Aquinas S R, Tarey S D, Ravindran G D, Nagamani D, Ross C
St. John's Medical College and Hospital, Bangalore.
J Assoc Physicians India. 1996 Mar;44(3):178-80.
Cryptococcal meningitis is the most common opportunistic fungal infection in patients with Acquired Immunodeficiency Syndrome (AIDS) contributing to the increased morbidity and mortality. This important infection in AIDS seems to be under diagnosed in India. We discuss the clinical features, laboratory diagnosis and therapy of seven cases of cryptococcal meningitis detected in our hospital. Diagnosis was established in all cases by identification of the fungus in cerebrospinal fluid (CSF) by India Ink preparation and positive fungal culture in CSF and/or Blood. Six patients were treated with Amphotericin B and Flucytosine. Two were cured and have not relapsed on suppressive therapy. Two died during treatment. Two were lost to follow up. All the three patients who died had positive fungal culture in blood and CSF. Presence of Cryptococcemia in Cryptococcal meningitis is an indicator of poor prognosis. A high index of clinical suspicion and routine mycological surveillance essential to identify this infection.
隐球菌性脑膜炎是获得性免疫缺陷综合征（AIDS）患者中最常见的机会性真菌感染，会导致发病率和死亡率上升。在印度，这种AIDS患者中的重要感染似乎未得到充分诊断。我们讨论了在我院检测到的7例隐球菌性脑膜炎的临床特征、实验室诊断和治疗情况。所有病例均通过印度墨汁染色法在脑脊液（CSF）中鉴定出真菌以及CSF和/或血液真菌培养阳性得以确诊。6例患者接受了两性霉素B和氟胞嘧啶治疗。2例治愈，接受抑制性治疗后未复发。2例在治疗期间死亡。2例失访。所有3例死亡患者的血液和CSF真菌培养均为阳性。隐球菌性脑膜炎患者存在隐球菌血症是预后不良的指标。高度的临床怀疑指数和常规真菌学监测对于识别这种感染至关重要。
