以步态不稳为首发症状的新型隐球菌性脑膜脑炎1例  

Cryptococcal meningoencephalitis with unstable gait as the initial symptom:A case report

作　　者：王瑶 黄鹏如 曾昭豪 罗宏 岑海媚 罗彬 张誉 Wang Yao;Huang Pengru;Zeng Zhaohao;Luo Hong;Cen Haimei;Luo Bin;Zhang Yu(Department of Neurology,the First Affiliated Hospital of Jinan University,Guangzhou 510632,China;Third Department of Neurology,Guangdong 999 Brain Hospital,Guangzhou 510510,China)

机构地区：[1]暨南大学附属第一医院神经内科,广东广州510632 [2]广东三九脑科医院神经内三科,广东广州510510

出　　处：《临床荟萃》2023年第3期260-263,共4页Clinical Focus

基　　金：国家自然科学基金资助项目——DYS△45-55基因修复的人脂肪干细胞源性肌肉祖细胞移植DMD模型鼠促进肌肉再生的研究(81801246)。

摘　　要：目的 探讨以步态不稳为首发症状的新型隐球菌性脑膜脑炎患者的临床特点。方法 分析1例以步态不稳为首发症状的新型隐球菌性脑膜脑炎的临床资料。结果 45岁男性,2年前出现步态不稳,进行性加重,并出现记忆力下降、反应迟钝等症状,头颅MR示脑室系统扩张,脑脊液检查发现隐球菌感染,经两性霉素B联合氟胞嘧啶抗真菌治疗后症状改善。结论 新型隐球菌性脑膜脑炎起病隐匿,可能以步态不稳为首发症状,临床中应注意排查。Objective To investigate the clinical characteristics of patients with cryptococcal meningoencephalitis with unstable gait as the initial symptom.Methods The clinical datas of a cryptococcal meningoencephalitis patient with unstable gait as the initial symptom were analyzed.Results A 45-year-old male presented with unstable gait two years ago,and the symptoms worsened progressively,complicated with decreased memory and delayed response.Brain MR scans showed dilation of the ventricular system,and cerebrospinal fluid examination revealed cryptococcal infection.After treatment with amphotericin B and fluorocytosine,the clinical symptoms improved.Conclusion Cryptococcal meningoencephalitis usually has an insidious onset,and unstable gait may be the initial symptom,which should be paid attention in clinical practice.

关 键 词：脑膜炎 隐球菌性 步态不稳 首发症状 

分 类 号：R515.2[医药卫生—内科学]