以眩暈及兩側突發性耳聾為主要表徵的隱球菌性腦膜炎－病例報告

Cryptococcal Meningitis Presenting with Vertigo and Bilateral Sudden Deafness - Case Report

朱世輝(Shih-Huei Chu) ； 李善敬(Sian-King Lie)

《中華民國耳鼻喉科醫學會雜誌》 27卷1期 (1992/03) Pp. 40-44

https://doi.org/10.6286/1992.27.1.40

摘要

隱球菌性腦膜炎是由新形隱球菌引起死亡率甚高的腦膜炎。一名55歲的女性病人在出現類似上呼吸道感染的症狀後不久，突然發生眩暈及兩側重度聽力障礎。在被當作原因不明的突發性耳聾而給予類固醇治療約一星期後，病人出現意識不清、劇烈頭痛、及嘔吐等情形。CSF的抹片檢查發現了新形隱球菌，才知道是隱球菌性腦膜炎。在給予amphotericin B, 5-flurocytosine, fluconazole等藥物治療後，病情終於獲得改善。由真菌感染而引起眩暈及兩側突發性耳聾的病例非常罕見，特提出報告。

關鍵字

隱球菌性腦膜炎 ； 兩側突發性耳聾 ； 眩暈

並列摘要

A 55-year-old woman presenting with vertigo and bilateral profound hearing loss of sudden onset following URI-like symptoms. She was first diagnosed as having idiopathic sudden deafness and received steroids. One week after steroid treatment, neurologic complication developed and Indian ink stain of cerebrospinal fluid revealed Cryptococcus neoformans.
Treatment with Amphotericin-B and 5-fluorocytosine saved her life but failed to restore her hearing. It is important to excluded occult pathologic factor with sudden deafness prior to embarking on a course of steroid therapy.

並列關鍵字

cryptococcal meningitis ； bilateral sudden deafness ； vertigo