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KMID : 0359819730020020119
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Journal of Korean Neurosurgical Society
1973 Volume.2 No. 2 p.119 ~ p.123
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A Case of Cryptococcal Meningitis
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李勳甲/Lee, H.K.
田春瑞/辛圭萬/盧敬正/김춘원/李基燦/朱正和/Jeon, c.S./Shin, K.M./Rho, H.J./Kim, C.W./Lee, K.C./Chu, J.W.
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Abstract
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A case of cryptococcal meningitis is reported, which occured in a 25-year old female whose chief compaints were severe headache, vomiting and double vision lasting one month.
Neurological examination on admission (September 7, 1973) showed no significant abnormalities except for the bilateral papilledema and subjective horizontal diplopia. Simple skull and chest films .including results of specific diagnostic procedures were grossly intact. Cerebrospinal fluid examination disclosed pleocytosis, increased protein, and decreased sugar and chloride, levels which was the finding compatible with those of. tuberculous meningitis etc. The subject was treated under the diagnosis of tuberculous meningitis.
Two weeks after the admisson, direct smear of the spinal fluid showed numerous yeast like cells, and cryptococcus neoformans was confirmed by India ink preparation and culture in Sabouraud´s glucose agar.
Amphotericin B was administered by slow intravenous drip over a span of several hours starting with 0.25 mg/kg of body weight and increasing gradually up to 1.25 mg/kg of body weight daily.
Clinical improvements of the patient´s condition along with disappearance of cryptococcus neoformans in CSF examination. were, obtained by the treatment with Amphoteric in B injection, although a fall in hemoglobin, hypopotassemia, moderate degree of fever and occasional vomiting were observed. as side effects during the, course of treatment.
Cryptococcus is highly fatal infection caused by cryptococcus neoformans which is a special predilections for the central nervous system. Crytococcosis may also involve the lungs, bones and skin, and occurs with increased frequency in patients with leukemia or lymphomas. This infection is most common in male adult, and the protal entry is the respiratory tract.
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