低抗原标位在免疫受损宿主中传播的密码球菌:两个具有挑战性的病例报告
Srishty Agarwal1, Vaishnavi M Rathod1, Muhammad Hussain1
1Department of Infectious Diseases, Mayo Clinic Florida, Jacksonville, FL, USA.
The American journal of case reports
|June 14, 2025
概括
散布式密码球菌病可以发生在免疫功能低下的患者中,即使真菌抗原水平较低,并且没有中枢神经系统的参与. 血液培养对于诊断这种侵入性真菌感染和指导治疗至关重要.
科学领域:
- 菌类学 菌类学是指菌类学.
- 传染性疾病 传染性疾病
- 免疫功能受损的宿主
背景情况:
- 加密球菌是一种类似酵母菌的真菌,主要在免疫受损的个体中引起疾病.
- 虽然中枢神经系统和肺部感染很常见,但传播的密码球菌病可以影响多个器官.
- 像头痛和发烧这样的症状需要彻底的诊断评估.
研究的目的:
- 为了突出传播的加密球菌病的不寻常表现.
- 强调非典型病例中血液培养的诊断价值.
- 强调在免疫功能低下,抗原标位低的患者中考虑密码球菌病的重要性.
主要方法:
- 介绍了两份关于加密球菌感染的病例报告.
- 包括那些为Cryptococcus阳性血液培养而没有脑膜炎的患者.
- 在血清和支气管支气管洗 (BAL) 或脑脊液 (CSF) 发现中分析低密码球菌抗原标位 (1:80) .
主要成果:
- 两名免疫功能低下的患者 (移植后,艾滋病毒) 呈现了扩散的密码球菌病.
- 这两种病例都显示出对Cryptococcus的阳性血液培养与低血清抗原标位 (1:80).
- 一名患者有阳性BAL的呼吸道症状,而另一名患者有阴性BAL和脑脊液但阳性血培养.
结论:
- 散布的加密球菌病可以不典型地表现为低血清抗原标位和阳性血液培养,即使没有中枢神经系统的参与.
- 血液培养对于识别传播的加密菌病和改变患者管理策略至关重要.
- 临床医生应保持高的怀疑密码球菌病的指数在免疫功能低下的患者呈现异常症状.
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