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近年来隐球菌性脑膜炎(简称隐脑)发病率有增加趋势。但因临床表现缺乏特征性而易误诊。我院1986至1990年收治隐脑2例均被误诊为结脑。现分析如下。例1,男,50岁。因畏寒发热月余,伴头痛10多天入院。入院前曾经当地中西医治疗20多天无效而转我院。病者有床头饲养鸽子多年史。体查:T 38℃,神清,颈抵抗,右侧克氏征阳性。入院后首次腰穿脊液清,压力高,蛋白(++),白细胞30×10~6/L,糖1.68 mmol/L。全胸片(-),五官科会诊双侧视神经乳头水肿。初诊结脑。使用抗痨、脱水、激素等治疗头痛未减,T 38～39℃之间,1周后复查脑脊液清,透明,蛋白(+),细胞数80×10~6/L,糖及氯化
In recent years, the incidence of cryptococcal meningitis (referred to as crypto) increased. However, due to the lack of clinical manifestations of the characteristics and easy to misdiagnosis. Our hospital from 1986 to 1990 admitted two cases of cryptococcal were misdiagnosed as knot brain. Analysis is as follows. Example 1, male, 50 years old. Due to chills and fever more than a month, with headache more than 10 days admitted to hospital. Before the hospital had the treatment of Chinese and Western medicine more than 20 days invalid and transferred to our hospital. The sick have bedside pigeons for many years. Physical examination: T 38 ℃, Shen Qing, neck resistance, right Kirschner symbol positive. For the first time after admission, lumbar intervertebral disc herniation, high pressure, protein (++), white blood cells 30 × 10 ~ 6 / L, sugar 1.68 mmol / L. Full chest radiograph (-), ENT bilateral optic papillae edema. Newly diagnosed knot brain. The use of anti-tuberculosis, dehydration, hormones and other treatment of headache is not reduced, T 38 ~ 39 ℃, 1 week after the review of cerebrospinal fluid clear, transparent protein (+), the number of cells 80 × 10 ~ 6 / L,