论文部分内容阅读
目的分析新型隐球菌脑膜炎(隐脑)的临床特点和疗效。方法对38例隐脑进行回顾性分析,所有患者均经病原学检查确诊。结果36例隐脑呈慢性或亚急性起病,初次脑脊液涂片确诊24例,经反复脑脊液涂片及培养确诊14例。38例中有8例未用药,其中2例自动出院,其余6例均死亡。30例行抗真菌治疗,治愈11例,好转7例,转院治疗8例,未愈出院2例,死亡2例。其中两性霉素B联合5-氟胞嘧啶治疗9例,6例治愈,3例好转。结论隐脑常易误诊、漏诊,反复行脑脊液涂片以及同时行真菌培养可提高诊断率。两性霉素B联合5-氟胞嘧啶治疗效果较好。
Objective To analyze the clinical features and therapeutic effects of Cryptococcus neoformans meningitis. Methods Retrospective analysis of 38 cases of implicit brain, all patients were confirmed by etiological examination. Results 36 cases of cryptorchidism was chronic or subacute onset, 24 cases of initial CSF smear confirmed by repeated cerebrospinal fluid smear and culture confirmed 14 cases. Eight of the 38 patients did not receive medication, 2 of whom were discharged spontaneously and the remaining 6 were dead. 30 cases were treated with antifungal therapy, 11 cases were cured, 7 cases improved, 8 cases transferred to hospital, 2 cases were cured and 2 cases died. Of which amphotericin B combined with 5-fluorocytosine treatment in 9 cases, 6 cases were cured, 3 cases improved. Conclusions Crypto often misdiagnosis, missed diagnosis, recurrent cerebrospinal fluid smear and simultaneous fungal culture can improve the diagnostic rate. Amphotericin B combined with 5-fluorocytosine treatment is better.