系统性红斑狼疮并发隐球菌性脑膜炎

Cryptococcus meningitis in a patient with systemic lupus erythematosus:a case report

报告1例系统性红斑狼疮(SLE)并发隐球菌性脑膜炎。患者女,21岁。妊娠晚期确诊为SLE,经大剂量甲泼尼龙联合环磷酰胺治疗后出现发热、头痛,血培养及脑脊液培养检出隐球菌,诊断为罗伦隐球菌性脑膜炎。给予两性霉素B、氟康唑、氟胞嘧啶联合抗真菌治疗后症状好转,脑脊液培养转阴。病程中以小剂量泼尼松维持SLE治疗。

A case of Cryptococcus meningitis in a patient with systemic lupus erythematosus （SLEI~ is reported. A 21-year- old female was diagnosed with SLE when she was in the third trimester of pregnancy. She had fever and headache following the treatment with high dose methyl-prednisolone and eyclophosphamide. Blood and cerebrospinal fluid （CSF） cultured grew Cryptococcus. A diagnosis of Cryptococcus meningitis was made. The symptoms were improved and CSF culture became nega- tive after the treatment with amphotericin B liposome, fluconazole, flucytosine, as well as anti-funga] agents. During the treat- ment, low dose prednisone was also given for maintenance therapy of SLE.