Pillay N, Simjee A E
S Afr Med J. 1976 Sep 25;50(41):1604-6.
The records of 24 patients with cryptococcal meningitis, admitted to King Edward VIII Hospital in Durban, were reviewed. There were 21 adults and 3 children over periods of 10 and 18 years, respectively. Slightly more males were affected. The age distribution was fairly even. The common clinical presentations were headache, neck stiffness, mental changes, cranial nerve palsies and papilloedema. The diagnosis was proved by the presense of Cryptococcus neoformans in the cerebrospinal fluid (CSF) in 21 of the patients, and in pathological tissue in the remaining 3 patients. A significant percentage of patients presented with an initial polymorphonuclear leucocyte predominance in the CSF. The other CSF findings were elevated protein and low sugar levels. Tuberculosis was the common coexisting disease. We found the mortality rate of 58% to be very high and a significant number of patients died even after adequate treatment with amphotericin B either singly or in combination with 5-fluorocytosine.
对德班爱德华八世医院收治的24例隐球菌性脑膜炎患者的病历进行了回顾。其中有21名成年人和3名儿童，病程分别为10年和18年。男性患者略多。年龄分布较为均匀。常见的临床表现为头痛、颈部僵硬、精神改变、脑神经麻痹和视乳头水肿。21例患者脑脊液（CSF）中发现新型隐球菌，其余3例患者在病理组织中发现新型隐球菌，从而证实了诊断。相当一部分患者脑脊液最初以多形核白细胞为主。脑脊液的其他检查结果为蛋白升高和糖水平降低。结核病是常见的并存疾病。我们发现58%的死亡率非常高，即使单独使用两性霉素B或与5-氟胞嘧啶联合进行充分治疗后，仍有相当数量的患者死亡。
