儿童新型隐球菌脑膜炎17例临床分析

Clinical analysis of 17 pediatric patients with cryptococcus neoformans meningitis

目的探讨儿童新型隐球菌脑膜炎的临床特点、早期诊断和治疗方法。方法回顾性分析17例经病原学检查确诊的新型隐球菌脑膜炎临床资料。结果院外误诊15例;两性霉素B联合氟康唑治疗13例;治愈、好转7例;死亡2例。结论儿童新型隐球菌脑膜炎是以发热和颅内压增高为主要特点,反复进行脑脊液检查有助于早期诊断。两性霉素B联合氟康唑治疗新型隐球菌脑膜炎仍然安全、有效。

Objective To investigate the clinical characteristics, early diagnosis, and the methods of therapy in children with cryptococcal meningitis. Methods A retrospective analysis was performed on the clinical data of 17 patients with cryptococcal men- ingitis. Results Fifteen children with cryptococcal meningitis were misdiagnosed before admission to our hospital. Seven of 13 patients totally recovered with amphotericin B and fulconazole therapy, two of them died. Conclusion The characteristic manifestation of cryptococcal meningitis in children mainly include fever and intracranial hypertension. It is helpful to make an early diagnosis by examination of cerebrospinal fluid performed repeatedly. The analysis indicates that amphotericin B and fluconazole combination therapy remains effective and is well tolerated in the treatment of Cryptococcus meningitis.