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目的 :了解隐球菌病的临床特征,提高临床医生对隐球菌病的认识。方法 :回顾性分析南京医科大学第一附属医院2007—2015年收治的69例确诊的隐球菌病患者。免疫功能正常和免疫功能受损的患者分别是43例和26例。结果 :最常见的感染部位是呼吸系统,其次是中枢神经系统。肺隐球菌病患者中,病变主要位于周围肺野和下肺;21例肺隐球菌病曾被误诊;PET/CT检查单发结节易误诊为肿瘤;41例肺隐球菌患者接受药物、手术或联合治疗,34例痊愈无复发,1例改善,1例死亡,5例失访。28例其他部位(隐球菌脑膜炎、隐球菌血症等)隐球菌病患者治愈15例,死亡10例,失访3例。结论:研究发现,隐球菌病患者中免疫功能正常患者的比例较高。呼吸系统最易感染,病变通常位于外周肺野和下肺,PET/CT仍可导致误诊。抗真菌治疗对肺隐球菌病治疗效果较好。隐球菌脑膜炎、隐球菌血症病死率高。
Objective: To understand the clinical features of cryptococcosis and improve clinicians’ understanding of cryptococcosis. Methods: A retrospective analysis of the First Affiliated Hospital of Nanjing Medical University from 2007 to 2015 admitted 69 cases of cryptococcosis patients. The patients with normal immune function and impaired immune function were 43 and 26, respectively. Results: The most common sites of infection were the respiratory system, followed by the central nervous system. Pulmonary cryptococcosis patients, the lesions mainly located in the surrounding lung field and lower lung; 21 cases of pulmonary cryptococcosis have been misdiagnosed; PET / CT single nodules easily misdiagnosed as tumor; 41 cases of pulmonary cryptococcosis patients receiving drugs, surgery Or combination treatment, 34 cases recovered without recurrence, 1 case improved, 1 case died and 5 cases lost to follow-up. 28 cases of other parts (cryptococcal meningitis, cryptococcal disease, etc.) Cryptococcal disease were cured in 15 cases, 10 patients died, 3 cases were lost to follow-up. Conclusion: The study found that cryptococcosis patients with a higher proportion of patients with normal immune function. The respiratory system is most susceptible to infection and the lesions are usually located in the peripheral lung and lower lungs. PET / CT can still lead to misdiagnosis. Antifungal therapy for the treatment of pulmonary cryptococcosis better. Cryptococcus meningitis, cryptococcosis high mortality.