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Permalink : https://petit.lib.yamaguchi-u.ac.jp/18496
山口医学 Volume 57 Issue 1
published_at 2008-02-29
Autoimmune Hemolytic Anemia Complicated by Cryptococcal Meningitis with Visual Loss and Hearing Difficulty
自己免疫性溶血性貧血に対して副腎皮質ステロイド投与中に全盲,難聴を伴うクリプトコッカス髄膜炎を発症した一症例
Adachi Mayumi
Matsui Kumiko
Nakabayashi Yoko
Kondo Manabu
Tominaga Takayuki
Matsuda Kazuhiro
Shinohara Kenji
About This Article
Descriptions
自己免疫性溶血性貧血において副腎皮質ステロイドにて治療中難治性のクリプトコッカス髄膜炎を発症した稀な症例を報告する.7年前より自己免疫性溶血性貧血にて副腎皮質ステロイド投与にて治療中の48歳の男性患者が4ヵ月前に頭痛,難聴,嘔気,嘔吐などを訴えクリプトコッカス髄膜炎を発症した.後に貧血の増悪のためにショック状態になり当科に紹介された.この間に視力障害,全盲,を合併した.貧血はm-PSLによるパルス療法により改善した.クリプトコッカス髄膜炎に対してはAMPH-B(注射用dAMPH-B,リポゾーム化剤,L-AMB),5-FC,アゾール剤であるFLCZおよびVRCZなどの投与により髄膜炎症状は消失した.抗真菌剤を1年半投与し,髄液中のクリプトコッカス抗原量は著明に減少したが陰性化せずまた墨汁染色ではクリプトコッカスの数は減少したが未だ完全には消失しておらず難治性であり視力障害,難聴は残存した.
Creator Keywords
自己免疫性溶血性貧血
クリプトコッカス髄膜炎
全盲
難聴
Other Article