隐球菌性腹膜炎合并结核性胸膜炎1例并文献复习

摘要/Abstract

摘要： 报道1例隐球菌性腹膜炎合并结核性胸膜炎病例的诊疗情况，并结合国内外相关报道进行文献回顾分析。患者，男，72岁，表现为腹胀伴轻咳，腹水培养确诊为隐球菌感染，予氟康唑（400 mg 1次/天）治疗4个月后，出现胸腔积液，经胸膜活检病理诊断结核性胸膜炎，加用抗结核治疗，胸腹水吸收。腹腔隐球菌感染较为少见，确诊主要依靠病原学检测，隐球菌荚膜抗原检测、腹水等临床标本的NGS检测可能是提高诊疗效率的办法之一。

关键词: 隐球菌, 隐球菌病, 腹膜炎, 结核性胸膜炎, 隐球菌荚膜抗原检测

Abstract: A case of cryptococcal peritonitis confirmed by ascites culture was described and literatures were reviewed. Case:a 72-year-old male patient complaining about abdominal distension and cough. Color Doppler ultrasound in the abdominal cavity indicated low-medium effusion, and ascites culture indicated cryptococcal infection. During the treatment with fluconazole(400 mg qd), pleural effusion occurred four months later, and tuberculous pleurisy was diagnosed pathologically by pleural biopsy. Anti-tuberculosis treatment was added, and the hydrothorax and ascites did not recur.Cryptococcal abdominal cavity infection is relatively rare. The diagnosis mainly depends on pathogenic testing. Cryptococcal capsular antigen testing and next-generation sequencing on clinical samples such as ascitic fluid may be one of the ways to improve the efficiency of diagnosis. Antifungal therapy for patients with normal immune function would achieve better result.

Key words: Cryptococcus, cryptococcosis, peritonitis, tuberculous pleurisy, cryptococcal polysaccharide

中图分类号:

R519.4A

谢玉凤, 吴国兰, 翁丽珍, 陈晓红, 邹盛华. 隐球菌性腹膜炎合并结核性胸膜炎1例并文献复习[J]. 中国真菌学杂志, 2022, 17(5): 394-398,401.

XIE Yufeng, WU Guolan, WEN Lizhen, CHEN Xiaohong, ZOU Shenghua. Cryptococcal peritonitis accompanied by tuberculous pleurisy: a case report and literature review[J]. Chinese Journal of Mycology, 2022, 17(5): 394-398,401.

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