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目的 提高对艾滋病 (AIDS)合并隐球菌脑膜炎的认识。方法 对赤道几内亚巴塔地区医院 1997年 1月～ 1999年 11月确诊的 18例AIDS合并隐球菌脑膜炎进行分析。结果 18例患者的临床主要表现为 :起病隐匿 ;发热、剧烈头痛、全身疼痛、恶心呕吐、消瘦脱水、颈淋巴结肿大、布氏征与克氏征阳性、巴彬氏征阳性 ;脑脊液检查 :隐球菌印度墨汁染色及隐球菌多糖荚膜抗原阳性率分别为77.8% ,94 .4 % ;脑脊液隐球菌培养均为阳性。病死率为 83 3%。结论 隐球菌脑膜炎是AIDS患者最常见的机会感染和致死病因。误诊及病死率高的主要原因系临床医生对本病的认识不足 ,治疗欠及时合理。
Objective To improve AIDS awareness of cryptococcal meningitis. Methods 18 cases of AIDS-associated cryptococcal meningitis diagnosed in Bata regional hospital of Equatorial Guinea from January 1997 to November 1999 were analyzed. Results The main clinical manifestations of 18 patients were: onset of insidiousness; fever, severe headache, generalized pain, nausea and vomiting, weight loss and dehydration, cervical lymph node enlargement, positive Brigssian sign and Klebsiella sign, positive Papn’s sign; cerebrospinal fluid examination : Cryptococcal Indian ink stain and Cryptococcal capsular antigen positive rates were 77.8%, 94.4%; cryptococcal cerebrospinal fluid were all positive. The case fatality rate was 83.3%. Conclusion Cryptococcal meningitis is the most common cause of opportunistic infections and deaths in AIDS patients. The main reason for misdiagnosis and high mortality is clinicians lack of understanding of the disease, the treatment is not timely and reasonable.