CRYPTOCOCCOSIS IN THE ACQUIRED IMMUNODEFICIENCY SYNDROME
CRYPTOCOCCOSIS IN THE ACQUIRED IMMUNODEFICIENCY SYNDROME
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DOI：
10.7326/0003-4819-103-4-533
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发表时间：
1985-01-01
影响因子：
39.2
通讯作者：
MASUR, H
中科院分区：
文献类型：
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作者：
KOVACS, JA;KOVACS, AA;MASUR, H
对 27 例隐球菌病和获得性免疫缺陷综合征患者的临床病程和治疗反应进行了回顾。 7 名患者的综合征最初表现为隐球菌病，另有 7 名患者最初表现为机会性感染。脑膜炎是最常见的临床特征（18 名患者）。血培养和血清隐球菌抗原经常呈阳性。在脑膜炎患者中，脑脊液中的白细胞计数、蛋白质水平和葡萄糖水平通常正常；脑脊液墨水试验（82%）、培养（100%）和隐球菌抗原（100%）通常呈阳性。完成治疗后，24 名患者中只有 10 名没有隐球菌感染临床活动的证据；临床发现或尸检显示，这 10 例中有 6 例复发。单独使用两性霉素 B 或与氟胞嘧啶联合使用标准疗程均无效。该综合征患者的隐球菌病是一种使人衰弱的疾病，对常规治疗没有反应。早期诊断或长期抑制治疗可能会改善预后。
The clinical course and response to therapy of 27 patients with cryptococcosis and the acquired immunodeficiency syndrome were reviewed. Cryptococcosis was the initial manifestation of the syndrome in 7 patients, and the initial opportunistic infection in an additional 7. Meningitis was the commonest clinical feature (18 patients). Blood cultures and serum cryptococcal antigen were frequently positive. In patients with meningitis, leukocyte count, protein level, and glucose level in cerebrospinal fluid were frequently normal; cerebrospinal fluid India ink test (82%), culture (100%), and cryptococcal antigen (100%) were usually positive. Only 10 of 24 patients had no evidence of clinical activity of cryptococcal infection after completion of therapy; 6 of these 10 had relapses shown by clinical findings or at autopsy. Standard courses of amphotericin B alone or combined with flucytosine were ineffective. Cryptococcosis in patients with the syndrome is a debilitating disease that does not respond to conventional therapy; earlier diagnosis or long-term suppressive therapy may improve the prognosis.