新型隐球菌性脑膜炎30例临床分析

目的分析30例隐球菌性脑膜炎的临床资料,以期提高对隐球菌性脑膜炎的认识。方法回顾性总结近30例隐球菌性脑膜炎的临床表现、辅助检查、误诊情况及治疗。结果采用二性霉素B、氟康唑和(或)5-氟胞嘧啶联合治疗,总有效率为78.6%。8例无效病人中7例死于脑疝。结论隐球菌性脑膜炎误诊率高,减少病死率的关键在于提高警惕,早期诊断,合理使用抗真菌药物,治疗仍首选二性霉素B加氟康唑和(或)5-氟胞嘧啶。

Clinical analysis of cryptococcal meningitis neoformans in 30 cases

Objective To raise the recognition of cryptococcal meningitis by analyzing 30 clinical datas. Methods Review 30 clinical datas of cryptococcal meningitis neoformans. Summary their clinical manifestation, auxiliary examination, misdiagnosis and therapy. Results The total effective rate was 78.6% by introducing therapeutic alliance of amphotericin B, fluconazol and (or) 5-fluorocytosine. There were 7 cases succumbing to cerebral hernia in the 8 ineffective patients.Conclusions The misdiagnosis rate of cryptococcal meningitis is high. The key point of decreasing the case-fatality rate lies on raising vigilance,early diagnosis and rational use of antimycotic drug.The primary selection of treatment is still to remain the therapeutic alliance of amphotericin B,fluconazol and(or)5-fluorocytosine.