慢性芽生菌脑膜炎极少见,至今世界记载的才40例。本文报告3例,对芽生菌病的发病、脑膜感染的机理和二性霉素 B 治疗结果等进行讨论。例1,53岁,男,1978年5月起有尿痛、尿频。9月出现头痛、颈强、恶心、呕吐、复视、前列腺肿大、触痛和神志不清等。脑脊液压力432mm 水柱,蛋白质144mg/dl、葡萄糖29mg/dl,白细胞计数388/mm~3,3次脑脊液涂片和培养检查细菌、抗酸杆菌和霉菌均阴性。经电子计算机 X 线断层照相检查(CT)发现脑室扩大。右侧脑室液查得皮炎芽生菌。用二性霉素 B 治疗,2天后死亡。尸检发现肺、前列腺和软脑膜均有芽生菌。例2,53岁,男,发热寒战盗汗和干咳3周,胸部 X 线检查示左肺上叶3 cm 结节,5 U PPD 结核菌素皮肤试验阳性。即开始异烟肼和乙胺丁醇治疗。5天后神志不清和尿失禁。经 CT 发现脑室扩大。脑脊液压力110mm 水柱,蛋白质121 mg/dl,葡萄糖28 Chronic blastomycosis meningitis is rare, the world recorded only 40 cases. This article reports 3 cases, the pathogenesis of blastomycosis, the mechanism of meningeal infection and amphotericin B treatment results are discussed. Example 1,53 years old, male, from May 1978 onwards dysuria, frequent urination. September headache, neck strong, nausea, vomiting, diplopia, enlargement of the prostate, tenderness and confusion. Cerebrospinal fluid pressure 432mmHg, protein 144mg / dl, glucose 29mg / dl, white blood cell count 388 / mm ~ 3,3 times cerebrospinal fluid smear and culture check bacteria, acid-fast bacilli and mold are negative. Ventricular enlargement was detected by computed tomography (CT). Right ventricular fluid check dermatitis blastomycetes. With amphotericin B treatment, died after 2 days. Autopsy found that the lungs, prostate and pia mater all have budding bacteria. Cases of male and female, fever, night sweats and dry coughs for 3 weeks, chest X-ray showed 3 cm nodules in the left upper lung and 5 U PPD tuberculin skin test positive. The start of isoniazid and ethambutol treatment. 5 days unconscious and incontinence. Ventricular enlargement was found by CT. Cerebrospinal fluid pressure 110mmHg, protein 121 mg / dl, glucose 28