隐球菌性脑膜炎的临床、脑脊液与影像学

目的 研究隐球菌性脑膜炎的临床特点。方法 收集我院1991－2000年间确诊隐球菌性脑膜炎的9例患者，并分析其相关资料。结果 9例患者中男性6例，女性3例。其起始症状均有头痛、发热，6例出现呕吐，意识障碍与发作性抽搐各1例。入院初诊1例误诊为伤寒，其余误诊为结核性脑膜炎、病毒性脑膜炎。多次腰穿行脑脊液检查隐球菌墨汁染色阳性。1例因同时并发急性心肌前间壁供血不足而死亡，余8例经抗真菌治疗后痊愈。结论 隐球菌性脑膜炎临床表现缺乏特异性，CT检查缺额特异性，MRI对病灶显示较清楚，脑脊液检查是确诊的最好的指标，早期诊断及早期治疗对疾病的转归及预后密切相关。

Clinical analysis, CSF and imaging in cryptococcosis meningitis patients

Objective To study the clinical characters of crytococcosis meningitis.Methods The relative deta in 9 patients with cyptococcosis meningitis 6 male and 3 female were analysed .Results The clinical symptoms were headache, fever, sickness, vomiting, confusion and convulsions. 8 patients were diagnosed with tuberculosis or virus meningitis except for one as typhoid. Ink stain in CSF was positive in all patients. 8 patients completely recovered by antifungal treatment except one died of acute myocardium ischemia. Conclusion The clinical characters are short of speciality. MRI can show focus better than CT. CSF was the best marker for diagosis. Early diagnosis and treatment were closely relative with the curative effect and prognosis.