Cryptococcosis, mainly caused by Cryptococcus neoformans/gattii species complexes, is a lethal infection in both immunosuppressive and immunocompetent populations. With the upgrade of detection methods and the increase of clinical knowledge, the incidence rate of cryptococcosis is increasing, and it has become one of the most important fungi threatening human health. In recent years, great progress has been made in this field, including the taxonomy and nomenclature of Cryptococcus spp., laboratory diagnostic methods and antifungal susceptibility tests, as well as the characteristics and treatments of cryptococcosis. This article reviews the above contents, in order to improve the clinical and laboratory understanding of the Cryptococcus spp., and realize the timely diagnosis and early treatment of cryptococcosis.
ObjectiveTo analyze the curative effect and prognosis of drug resistant tuberculosis meningitis (TBM). MethodsRetrospective analysis was carried out on the clinical data of thirty-two cases of drug resistant tuberculous meningitis patients hospitalized from January 2010 to December 2015. And the prognosis of the patients was evaluated by meliorated Rankin Scale (mRS). ResultsThirty-one cases (96.9%) were improved in 32 patients with drug resistant TBM, and 1 case (3.1%) was ineffective. After treatment, one patient had hormone-related glaucoma and osteoporosis, and one patient had drug Cushing syndrome. Twenty-seven patients (84.4%) had an mRS score equal to or less than 2 points. ConclusionDrug resistant TBM is difficult to diagnose in the early stage, and the curative effect is satisfying with active anti-tuberculosis treatment.
【摘要】 目的 分析总结妊娠合并结核性脑膜炎患者的相关特征及护理经验。 方法 对2010年1-12月收治的8例妊娠合并结核性脑膜炎患者的相关资料进行回顾性分析，并就疾病特点所采取的有效护理措施进行表述。 结果 6例患者好转出院继续治疗（均于出院后1周内终止妊娠），1例经抢救后转院行引产手术，1例因经济原因自动出院。 结论 应大力普及妊娠期结核性脑膜炎相关知识，重视首发症状及腰椎穿刺检查结果，做到早发现，早诊断，早治疗，并采取相应的护理措施，减少并发症和致死率。【Abstract】 Objective To summarize the characteristics of pregnant women with tuberculous meningitis and the nursing measures for these patients. Methods The clinical data of 8 pregnant patients with tuberculous meningitis diagnosed between January 2010 and December 2010 were retrospectively analyzed. The characteristics of race, admitting diagnosis, basis diseases, premiers symptoms, and course of disease were analyzed, and the nursing measures were summarized. Results Six patients recovered and left the hospital (all had terminationed pregnancy after discharge within one week), one was transferred to another hospital for induction of labor after emergency rescue, one left the hospital for economical reason. Conclusions The propagation of the knowledge of tuberculous meningitis is very important. We should pay more attention to its early symptoms, corning′s puncture examination and give suitable nursing care as soon as possible.
Objective To investigate the clinical features of tuberculous meningoencephalitis.Methods The clinical characteristics and laboratory results of 126 cases who were diagnosed as tuberculous meningoencephalitis fromJanuary 2000 to April 2009 were analyzed retrospectively. Results The clinical manifestations of tuberculous meningoencephalitis included fever, headache, vomitting, hemiparalysis,paraplegia, mental anomaly, hypopsia, deafness, diplopia, muscular spasms, coma, and incomplete oculomotor palsy, etc. Vomitting which was characteristic symptom of tuberculous meningoencephalitis was found in 25 cases( 19. 8% ) . The diagnosis was confirmed more than eightweeks after the onset of the disease in 31 cases ( 24. 6% ) . The inhospital mortality rate of tuberculous meningoencephalitis was 14. 3% ( 18 /126) . The inhospital mortality rate of re-treatment patients was 42. 9% ( 6 /14) . In 41 patients with poor prognosis ( death or therapy failure) , 68. 3% ( 28/41) cases were complicated with military tuberculosis, which was higher than the overall occurrence of 41. 3% ( 52/126) . Conclusions Strict diagnostic criteria and atypicalsymptoms lead to delayed diagnosis, delayed treatment, and high mortality in patients with tuberculous meningoencephalitis, particularly in patients with military tuberculosis and re-treatment patients. There is still no effective treatment which have a significant impact on the prognosis.
Anthrax is a zoonotic, acute infectious disease caused by Bacillus anthracis. Anthrax meningitis is one of the most dangerous types of anthrax, mostly secondary to cutaneous, intestinal, and pulmonary anthrax, and is a central nervous system infectious disease that is extremely lethal in the absence of timely treatment. This article reviews the clinical characteristics, pathogenesis, diagnosis and treatment of anthrax meningitis, in order to provide some reference for the clinical diagnosis and treatment of anthrax meningitis in China, and to provide reference for the further development of anthrax meningitis research.
ObjectiveTo investigate the epidemiological and economic burden of acute meningitis and encephalitis syndrome (AMES) in Jinan, so as to provide references for prevention and control of AMES. MethodsThe monitoring data of the AMES Special Reporting System of Jinan City from 2007 to 2014 was collected and the epidemiological characteristics of AMES were analyzed. A questionnaire survey was performed in AMES patients reported in 2013 to collect the basic information, prognosis, medical and non-medical expenses etc. of patients. The DALYs and economic burden of AMES were estimated by using SPSS 13.0 software. ResultsThe average incidence rate of AMES in Jinan was 8.49/100 000 through 2007 to 2014 and the mortality was 4.96‰. The total DALYs were 36 659.51 and the average DALY was 8.27.77.86% were aged less than 14 years old. The average direct economic burden of each case was 19.5 thousand RMB and the average indirect economic burden caused by DALYs was 69.1 thousand RMB. ConclusionThere's heavy burden from AMES, and measures should be made to reduce the incidence and economic burden.
Objective To systematically review the risk factors for death in children with tuberculous meningitis (TBM). Methods The CNKI, VIP, WanFang Data, CBM, Cochrane Library, Web of Science, PubMed, EMbase and CINAHL databases were electronically searched to collect studies on the risk factors for death in children with TBM from inception to October 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. Results A total of 15 studies involving 2 597 patients were included. The results of meta-analysis showed that male (OR=2.41, 95%CI 1.61 to 3.61, P<0.01), no history of BCG vaccination (OR=3.74, 95%CI 1.96 to 7.12, P<0.01), TBM stage (stage Ⅲ) (OR=2.04, 95%CI 1.26 to 3.28, P<0.01), HIV infection (OR=3.28, 95%CI 1.20 to 8.93, P=0.02), convulsion (OR=3.61, 95%CI 3.31 to 3.94, P<0.01), disturbance of consciousness (OR=3.58, 95%CI 2.40 to 5.34, P<0.01), cerebrospinal fluid protein concentration increased (OR=1.87, 95%CI 1.39 to 2.51, P<0.01), hydrocephalus (OR=2.44, 95%CI 1.60 to 3.71, P<0.01) and short hospitalization (OR=2.89, 95%CI 2.05 to 4.06, P<0.01) were risk factors for death in children with TBM. Under 5 years old, negative PPD skin test, positive meningeal irritation sign, malnutrition and history of contact with TB may not be associated with the death of TBM in children. Conclusion Male, no history of BCG vaccination, TBM stage (stage Ⅲ), HIV infection, convulsions, disturbance of consciousness, cerebrospinal fluid protein concentration increased, hydrocephalus and short hospitalization are risk factors for death in children with TBM. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.