Clinical analysis of 69 cases of non-HIV-related cryptococcal meningitis
10.3760/cma.j.cn114798-20190927-00731
- VernacularTitle:非人类免疫缺陷病毒相关隐球菌性脑膜炎69例临床分析
- Author:
Xuejiao QI
1
;
Hui BU
;
Xiaoming FAN
;
Yueli ZOU
;
Junying HE
Author Information
1. 河北医科大学第二医院神经内科，石家庄 050000
- From:
Chinese Journal of General Practitioners
2020;19(4):349-351
- CountryChina
- Language:Chinese
-
Abstract:
The clinical data of 69 patients with non-HIV-related cryptococcal meningitis admitted in the Second Hospital of Hebei Medical University from January 2013 to May 2019 were analyzed retrospectively.The main presentations of 69 patients are headache,fever,nausea,vomiting, visual impairment, hearing damage.Among them, 36 cases (52%) had underlying diseases, 30 cases (43%) were misdiagnosed, and 38 cases (55%) were complicated with high intracranial pressure. Cerebrospinal fluid examination showed that leukocytes increased in 47 cases, protein increased in 55 cases, chloride decreased in 41 cases, glucose decreased in 34 cases. The imaging findings were cerebral ischemia, hydrocephalus, meningeal or cerebral parenchyma enhancement. During the induction period, 63 cases were treated with combined antifungal drugs and 6 cases were treated with single antifungal drugs. The clinical symptoms were improved in 54 cases, 9 cases were discharged automatically and 6 cases died. The clinical manifestations, routine and biochemical examination of cerebrospinal fluid, imaging findings are not specific for patients with non-HIV-related cryptococcal meningitis.So early and multiple lumbar puncture should be performed to find etiological evidence to reduce misdiagnosis. The combination of antifungal drugs during the induction period is safe and effective.
