COVID-19,艾滋病毒和加密球菌脑膜炎与异常实验室发现的共同感染
Mina Aghamali1,2, Abdolhassan Kazemi3, Mohammad Asgharzadeh4
1Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Case reports in pulmonology
|November 30, 2023
概括
艾滋病毒阳性患者的COVID-19和加密球菌脑膜炎的同时感染显示出正常的prokalcitonin水平. 脊髓培养和染色等诊断方法至关重要,因为抗原检测可能是错误的负.
科学领域:
- 传染性疾病 传染性疾病
- 神经学 神经学
- 关键护理医学 关键护理医学
背景情况:
- 严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 在2019年出现,导致全球大流行.
- 克里普托科库斯新型菌 (Cryptococcus neoformans) 是人类免疫缺陷病毒 (HIV) 感染者的真菌脑膜炎的主要原因.
- 实验室诊断的进步旨在快速识别脑膜炎.
研究的目的:
- 在HIV阳性患者中报告COVID-19和加密球菌脑膜炎的同时感染病例.
- 为了突出这种共感染场景中不寻常的实验室发现.
- 强调脑膜炎综合诊断方法的重要性.
主要方法:
- 通过聚合酶链反应 (PCR) 和CT扫描确认了COVID-19的诊断.
- 通过脑脊液 (CSF) 分析,包括印度墨水染色和CSF培养,研究了加密球菌脑膜炎.
- 监测了实验室参数,如CSF中的甲和蛋白质水平.
主要成果:
- 在CSF中进行的加密球菌抗原测试产生了负结果,但印度墨水染色和CSF培养证实了C. neoformans.
- 尽管病情危急,血清和脑液中的前素水平仍然异常低,在正常范围内.
- 最初的CSF分析显示蛋白质含量升高,在重复测试后降低.
结论:
- 正常的公素水平并不能排除感染艾滋病毒相关的密码球菌脑膜炎,即使是同时出现的COVID-19.
- 菌抗原检测可以产生假阴性结果,不应该是唯一的诊断方法.
- 脊髓菌培养和染色对于诊断传染性脑膜炎至关重要,特别是当抗原测试呈阴性且脊髓菌形状不显著时.
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