[SP2-2F-2] Clinical Analysis of 45 Children Cases with Cryptococcus Meningitis
Objective: To analyze the clinical characteristics and treatment of cryptococcus meningitis（CM） in 45 patients, and to explore effective treatment measures.
Method: Clinical manifestations, therapy and prognosis of 45 patients with CM diagnosed by department of Pediatrics, Xiangya Hospital were analyzed, retrospectively.
Results: The total of 45 patients was with no history of AIDS. The most popular clinical manifestations were fever, headache, vomiting, convulsions, altered consciousness, visual disturbances and limb movement disorder. According to the treatment strategies, the cure rate of amphotericin B/liposome combined with flucytosine group was 85.7%, higher than amphotericin B monotherapy group (46.7%); in combination with surgical intervention, the cure rate of the non- intrathecal injection group was 76.9%, higher than the intrathecal group (70%); the induction treatment duration was longer than previously reported, accounting for 42.1% in 4-8 weeks, 28.9% in 8-12 weeks. After treatment, 68.9% of patients were clinically cured, 3 patients died.
Conclusions: Compared with crowd susceptibility, clinical manifestations, treatment options, dosage and induction treatment time, Chinese people are quite different from Caucasian and African. For Chinese CM patients, the treatment option of amphotericin B/liposome in combination with flucytosine acquired good effect, but poor tolerance with high doses of amphotericin B/liposome. However, the extended induction therapy stategy with low-doseage of amphotericin B/liposome may be an effective remedy. Intrathecal treatment did not improve the clinical cure rate of patients with CM. Early surgical intervention for severe intracranial hypertension patient could effectively reduce neurological sequelae, improve the cure rate.
Method: Clinical manifestations, therapy and prognosis of 45 patients with CM diagnosed by department of Pediatrics, Xiangya Hospital were analyzed, retrospectively.
Results: The total of 45 patients was with no history of AIDS. The most popular clinical manifestations were fever, headache, vomiting, convulsions, altered consciousness, visual disturbances and limb movement disorder. According to the treatment strategies, the cure rate of amphotericin B/liposome combined with flucytosine group was 85.7%, higher than amphotericin B monotherapy group (46.7%); in combination with surgical intervention, the cure rate of the non- intrathecal injection group was 76.9%, higher than the intrathecal group (70%); the induction treatment duration was longer than previously reported, accounting for 42.1% in 4-8 weeks, 28.9% in 8-12 weeks. After treatment, 68.9% of patients were clinically cured, 3 patients died.
Conclusions: Compared with crowd susceptibility, clinical manifestations, treatment options, dosage and induction treatment time, Chinese people are quite different from Caucasian and African. For Chinese CM patients, the treatment option of amphotericin B/liposome in combination with flucytosine acquired good effect, but poor tolerance with high doses of amphotericin B/liposome. However, the extended induction therapy stategy with low-doseage of amphotericin B/liposome may be an effective remedy. Intrathecal treatment did not improve the clinical cure rate of patients with CM. Early surgical intervention for severe intracranial hypertension patient could effectively reduce neurological sequelae, improve the cure rate.