艾滋病合并隐球菌性脑膜炎的临床与影像学特征

新发传染病电子杂志 ›› 2020, Vol. 5 ›› Issue (1): 56-59.

艾滋病合并隐球菌性脑膜炎的临床与影像学特征

袁虹¹, 胡志亮², 许传军³

1.深圳市第三人民医院神经内科,广东深圳 518112;
2.南京中医药大学附属南京医院,南京市第二医院感染科,南京 210003;
3.南京中医药大学附属南京医院,南京市第二医院放射科,南京 210003

出版日期:2020-01-20 发布日期:2020-04-22
通讯作者: 许传军,Email:xchuanjun@163.com
基金资助:
1.江苏省“十三五科教强卫工程”青年医学重点人才项目（QNRC2016059）; 2.南京市医学科技发展项目（ZKX17040）

Clinical and imaging features of acquired immunodeficiency syndrome associated with cryptococcal meningitis

Yuan Hong¹, Hu Zhiliang², Xu Chuanjun³

1.Department of neurology, The Third Hospital of Shenzhen, Guangdong Shenzhen 218000, China;
2.Department of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China;
3.Department of Radiology. The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China

Online:2020-01-20 Published:2020-04-22

摘要/Abstract

摘要： 艾滋病合并隐球菌性脑膜炎是一种致死性中枢神经系统感染性疾病,是世界范围内人体免疫缺损病毒（HIV）相关死亡的最主要原因之一,其临床表现多种多样,大部分患者呈慢性发病,主要表现包括发热(低热和中等度发热)、渐进性头痛及重者精神错乱、嗜睡等。隐球菌性脑膜炎病灶的部位有一定特征,可表现为两侧基底节区异常信号。影像表现特征是血管周围间隙(VRS)改变,可表现为VRS的扩大或胶样囊肿的形成;或脑实质的损害,隐球菌感染病灶突破血-脑脊液屏障后可在脑实质内、沿室管膜或脉络丛形成肉芽肿,呈结节状(隐球菌瘤),大小为5~20mm。增强MRI可见病灶轻度或中度强化,依据病灶出现的部位和增强后强化的特征可做出临床诊断。

关键词: 艾滋病, 隐球菌性脑膜炎, 影像诊断

Abstract: AIDS-associated with cryptococcal meningitis is a fatal infectious disease in the central nervous system, which is the main cause of HIV-related mortality worldwide. The clinical manifestations show the disease has a chronic process. The main clinical manifestations include fever (low fever and moderate fever), progressive headache, severe mental disorder, drowsiness, and etc. The location of cryptococcal meningitis lesions has certain characteristics, which can show abnormal signals in the both sides of basal ganglia. The imaging feature is the change of Virchow Robin space (VRS), which can be manifested as the dilated VRS gelatinous pseudocyst, and the damage of brain parenchyma. After cryptococcus infection breaks through the blood-brain barrier, it can form granuloma in brain parenchyma, that with ependyma or choroid plexus with the size of 5-20 mm. On contrast-enhanced MRI, mild or moderate enhancement of the lesions can be seen. Clinical diagnosis can be made by the location of the lesions and the characteristics of enhancement.

Key words: Acquired immunodeficiency syndrome, Cryptococcal meningitis, Imaging diagnosis

袁虹, 胡志亮, 许传军. 艾滋病合并隐球菌性脑膜炎的临床与影像学特征[J]. 新发传染病电子杂志, 2020, 5(1): 56-59.

Yuan Hong, Hu Zhiliang, Xu Chuanjun. Clinical and imaging features of acquired immunodeficiency syndrome associated with cryptococcal meningitis[J]. Electronic Journal of Emerging Infectious Diseases, 2020, 5(1): 56-59.

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