Clinical analysis of 26 cases with cryptococcal meningitis

Abstract

Objective To study the clinical features of cryptococcal meningitis (CM) and summarize its clinical manifestations, laboratory data, differential diagnosis and treatment, so as to discuss the treatment progress of CM.  Methods Clinical data of 26 cases with CM were retrospectively analyzed, and the treatment experiences were summarized.  Results All patients had headache and fever, and were positive for cerebrospinal fluid (CSF) latex agglutination test. Twenty-one patients' CSF smear were found Cryptococcus neoformans. Almost 76.92% (20/26) of patients were cured or became better after receiving combined treatment of amphotericin B, flucytosine and fluconazole. The symptoms and signs of 4 patients who received combined treatment of amphotericin B and voriconazole were greatly improved.  Conclusions CM can prone to be misdiagnosed at early stage. CSF smear and fungi culture are beneficial to the diagnosis. Latex agglutination test is a quick and easy examination to reduce the misdiagnosis rate of CM. The combination of amphotericin B, flucytosine and fluconazole is effective for the treatment of CM.

doi: 10.3969/j.issn.1672-6731.2014.08.009