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目的 研究隐球菌性脑膜炎的临床特点。方法 收集我院 1991～ 2 0 0 0年间确诊隐球菌性脑膜炎的 9例患者 ,并分析其相关资料。结果 9例患者中男性 6例 ,女性 3例。其起始症状均有头痛、发热 ,6例出现呕吐 ,意识障碍与发作性抽搐各 1例。入院初诊 1例误诊为伤寒 ,其余误诊为结核性脑膜炎、病毒性脑膜炎。多次腰穿行脑脊液检查隐球菌墨汁染色阳性。1例因同时并发急性心肌前间壁供血不足而死亡 ,余8例经抗真菌治疗后痊愈。结论 隐球菌性脑膜炎临床表现缺乏特异性 ,CT检查缺乏特异性 ,MRI对病灶显示较清楚 ,脑脊液检查是确诊的最好的指标 ,早期诊断及早期治疗对疾病的转归及预后密切相关。
Objective To study the clinical features of cryptococcal meningitis. Methods Nine patients with cryptococcal meningitis in our hospital from 1991 to 2000 were collected and analyzed. Results Among the 9 patients, 6 were males and 3 females. The initial symptoms of headache, fever, vomiting in 6 cases, disturbance of consciousness and seizures in 1 case. One patient admitted to the hospital was misdiagnosed as typhoid fever and the others were misdiagnosed as tuberculous meningitis and viral meningitis. Multiple lumbar puncture cerebrospinal fluid cryptococcal ink stain positive. One patient died of concurrent hypothyroidism with anterior myocardial infarction, and more than 8 cases were cured after antifungal therapy. Conclusions The clinical manifestations of cryptococcal meningitis are lack of specificity. The specificity of CT examination is not specific. MRI shows the lesions clearly. Cerebrospinal fluid examination is the best indicator of diagnosis. Early diagnosis and early treatment are closely related to prognosis and prognosis.