Details

Autor(en) / Beteiligte

• 최혜미
• Hye Mi Choi
• 정금모
• Gum Mo Jung
• 이웅기
• Woong Ki Lee
• 이혁수
• Hyeuk Soo Lee
• 김병선
• Byung Sun Kim
• 성충실
• Choong Sil Seong
• 윤소희
• So Hee Yoon
• 조용근
• Yong Keun Cho

Titel

증례 간성 뇌증과 감별이 어려웠던 C형간염 간경변증 환자의 크립토코쿠스뇌수막염

Ist Teil von

• The Korean journal of gastroenterology, 2014-11, Vol.64 (5), p.294

Ort / Verlag

대한소화기학회

Erscheinungsjahr

2014

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Cryptococcus neoformans, an encapsulated fungus, is an important opportunistic pathogen that can cause meningitis in immunocompromised patients. Since patients with cryptococcemia have high mortality, it is essential to make an early diagnosis and promptly initiate antifungal therapy. However, it is often very difficult to differentiate between cryptococcal meningitis and hepatic encephalopathy in patients with liver cirrhosis, and there is delay in making the diagnosis. Therefore, these patients have a particularly grave prognosis and consequently many patients die before culture results become available. In one study, starting antifungal therapy within 48 hours of the blood culture was associated with improved survival, but patients with liver cirrhosis were significantly less likely to receive antifungal therapy within 48 hours compared to those without liver cirrhosis. Recently, the authors experience a case of a 68-year-old woman with liver cirrhosis who presented with fever and a drowsy mental status. She had a previous history of having been admitted for infection-associated hepatic encephlopathy. Cryptococcal meningitis and cryptococcemia were diagnosed by spinal puncture and culture of cerebrospinal fluid. In spite of adequate treatment, the patient developed multi-system organ failure and eventually expired. Herein, we report a case of cryptococcal meningitis mimicking hepatic encephalopathy in a patient with liver cirrhosis. (Korean J Gastroenterol 2014;64:294-297)