摘要
目的探讨隐球菌血流感染的临床特点。方法收集苏州大学附属第一医院2006年12月至2017年12月确诊的隐球菌血流感染16例，分析其临床表现、治疗及预后。结果16例患者的临床表现中以发热最常见（12／16），合并有中枢神经系统隐球菌感染时可有头晕头痛、恶心呕吐、脑膜刺激征阳性等表现；存在基础疾病的有11例，多数为恶性血液病、糖尿病等；有侵袭性操作者12例，低蛋白血症6例，应用糖皮质激素者4例，应用广谱抗生素≥l周者5例；16例患者中死亡8例，好转6例，因确诊艾滋病而转至专科医院继续治疗的有2例。结论隐球菌血流感染最常见的临床表现为发热，以中等度热为主；基础疾病、侵袭性操作、低蛋白血症、应用糖皮质激素、应用广谱抗生素≥1周是引起隐球菌血流感染的易感因素，本病治疗困难，病死率高，预后差。
Objective To explore the clinical characteristics of cryptococcus bloodstream infection. Methods A retrospectively analysis was performed by collecting data of clinical manifestations, underlying diseases, susceptible factors, therapy and prognosis of cryptococcus bloodstream infection in the First Affiliated Hospital of Soochow University from December 2006 to December 2017. Results The most common symptom of the 16 patients was fever （ 12/16 ）. When combined with cryptococcus infection of central nervous system, the manifestations may include dizziness, headache, nausea and vomiting. Among the 16 patients, 11 cases had underlying diseases, which listed as leukemia, lymphoma, diabetes mellitus, hepatitis B, cirrhosis, chronic kidney disease and carcinoma of the liver; 12 cases had invasive procedures, 6 cases had hypoproteinemia, 4 cases had long-term usage of glucocorticoids, and 5 cases received broad spectrum antibiotics longer than 1 week. 8 cases died, 6 cases improved and 2 cases were transferred to the specialized hospital for their newly diagnosed AIDS. Conclusions Bloodstream infection of cryptococcus is a relatively rare disease. Fever is one of the most common symptoms of cryptococcus bloodstream infection. Underlying diseases, invasive procedures, hypoproteinemia, long-term application of glucocorticoids and antibiotics are the risk factors for cryptococcus bloodstream infection.
作者
苏青青
缪柯淳
张新月
郭晶晶
陈延斌
Su Qingqing;Miao Kechun;Zhang Xinyue;Guo Jingling;Chen Yanbin(Department of Pulmonary and Critical Care Medicine,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第35期2824-2826,共3页
National Medical Journal of China
关键词
隐球菌病
出血性败血症
血流感染
Cryptococcosis
Hemorrhagic septicemia
Bloodstream infection
