Cerebral Cryptococcosis in a Child

孩童期腦部隱球菌症：一病例報告

洪伯誠(Po-Cheng Hung) ； 王煇雄(Huei-Shyong Wang) ； 周明亮(Min-Lian Chou) ； 孫佩傑(Pei-Chien Sun) ； 黃嵩雀(Song-Chei Huang)

《Acta Paediatrica Sinica》 36卷2期 (1995/04) Pp. 131-135

https://doi.org/10.7097/APS.199504.0131

摘要

一名12歲女孩，因爲頭痛、嘔吐、左眼痛、腹視、頭暈及走路不穩定而來本院檢查，腦脊髓液穿刺發現有隱球菌，並且在血清及腦脊髓液中隱球菌抗原檢查皆呈現陽性，腦部磁振照影檢查顯示出在右側小腦半球有不正常的T2訊號增加，此訊號比腦部電腦斷層更加清楚。病患接受amphotericin-B及5-flucytosine治療，並然明顯副用作，唯治療6週後，停掉amphotericin-B 3天後，症狀再發，施以另-6週治療後，反應不錯，迄今3年未再複發。
本病例在兒科領域中並不多見，本文除報告此一例之臨床所見外，並對此病之診斷及治療加以討論。

關鍵字

腦部隱球菌症 ； 磁振照影 ； 電腦斷層

並列摘要

Reported is one case of cerebral cryptococcosis in a 12-year-old girl. The diagnosis was confirmed by the detection of Cryptococcus neoformans with both India ink preparation of the cerebrospinal fluid and Sabouraud’s media culture. Clinical presentation included progressive severe headache, vomiting, left eye pain, diplopia, dizziness and unstable gait. Fever was absent as a symptom. Initial brain magnetic resonance imaging revealed a focal lesion over the right cerebellar hemisphere with better demonstration than contrast-enhanced computed tomography. The patient was treated with amphotericin B and 5-flucytosine with good final outcome. Early diagnosis and proper therapy are necessary in order to decrease the motality of cerebral cryptococcosis.

並列關鍵字

cerebral cryptococcosis ； magnetic resonance imaging ； computed tomography