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在中枢神经系统的真菌感染中,以新型隐球菌所致的脑膜炎最常见。临床表现主要是颅内高压症和脑膜刺激征,也可有意识障碍、精神紊乱、抽搐和瘫痪,加上大多为缓慢或亚急性起病,病程较长或反复发作,容易误诊为其它疾病,致使治疗不及时。故此,病死率仍甚高。尽管自1956年临床使用二性霉素B治疗以来,新型隐球菌脑膜炎(隐球菌脑膜炎)的治愈率有极大提高,但由于使用不当、防治合并症或药物副作用不及时,常导致严重的后果。因此,隐球菌脑膜炎成为中枢神经系统感染、尤其是脑膜炎诊治上的一个备受关切的课题。现介绍日常医疗工作中所遇到的诊治失误的实例,供大家在临床诊治时参考、借鉴。
Meningitis caused by Cryptococcus neoformans is most common in central nervous system fungal infections. Clinical manifestations are mainly intracranial hypertension and meningeal irritation, but also may have disturbance of consciousness, mental disorders, convulsions and paralysis, coupled with mostly slow or subacute onset, longer duration or recurrent, easily misdiagnosed as other diseases, resulting in Treatment is not timely. Therefore, the case fatality rate is still very high. Although the cure rate of Cryptococcus neoformans meningitis (cryptococcal meningitis) has been greatly increased since the clinical use of amphotericin B in 1956, due to improper use, the prevention of comorbidities or the untimely side effects of the drug often leads to serious s consequence. Therefore, cryptococcal meningitis has become a subject of great concern in the diagnosis and treatment of central nervous system infections, especially meningitis. Now introduce the daily medical work encountered in the diagnosis and treatment of mistakes for your reference in clinical diagnosis and treatment, for reference.