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AIDS并发的隐球菌性脑膜炎(CM)在非洲是一日益严重的问题。此病凶险,为致死性感染,早期不易确诊,二性霉素等治疗较果较差。作者用氟康唑治疗64例(41例最后有疗效观察),其中58例为脑膜脑炎型,3例为脑肿瘤型,3例无症状,10%的患者为以往CM复发病例。AIDS的CM确诊以脑脊液 (CSF)做印度墨汁涂片直接镜检和(或)沙氏基培养阳性结果为依据,辅以血及CSF中的隐球菌抗原测定。治疗在病程急性期给氟康唑400mg/d,真菌学检查阴转后,减药量至200mg/d维持。在治疗的1,15,30,60,90天均分别做常规的CSF真菌学检查,30例于培养检查的当天还做了测定血及CSF
AIDS complicated by cryptococcal meningitis (CM) in Africa is a growing problem. The disease is dangerous, fatal infection, not easily diagnosed early, amphotericin and other treatment worse. The authors treated with fluconazole in 64 cases (41 patients with the final effect of observation), of which 58 were meningoencephalitis type, 3 were brain tumor type, 3 asymptomatic, 10% of patients with previous CM recurrence. The diagnosis of AIDS was based on the positive results of direct microscopic examination of cerebrospinal fluid (CSF) in Indian ink smears and / or positive cultures of Sarscher base, supplemented with cryptococcal antigen in blood and CSF. Treatment in the acute phase of flu to cones fluconazole 400mg / d, mycological examination after the negative transfer to reduce the dose to 200mg / d maintenance. Conventional CSF mycological tests were performed at 1, 15, 30, 60, and 90 days of treatment, respectively. On the day of the culture test, 30 patients were also tested for blood and CSF