Histopathology of the arachnoid granulations and brain in HIV-associated cryptococcal meningitis: correlation with cerebrospinal fluid pressure

被引：50

作者：

Loyse, Angela ^{[1
,2
,3
]}

Wainwright, Helen ^{[4
]}

Jarvis, Joseph N. ^{[1
,2
,3
,5
,6
]}

Bicanic, Tihana ^{[1
,2
,3
]}

Rebe, Kevin ^{[1
,5
,6
]}

Meintjes, Graeme ^{[1
,5
,6
]}

Harrison, Thomas S. ^{[3
]}

机构：

[1] Univ Cape Town, GF Jooste Hosp, Infect Dis Unit, ZA-7925 Cape Town, South Africa

[2] Univ Cape Town, Desmond Tutu HIV Ctr, Inst Infect Dis & Mol Med, ZA-7925 Cape Town, South Africa

[3] St George Hosp, Sch Med, Div Infect Dis, Dept Cellular & Mol Med, London, England

[4] Univ Cape Town, Dept Pathol, ZA-7925 Cape Town, South Africa

[5] Univ Cape Town, Div Infect Dis, ZA-7925 Cape Town, South Africa

[6] Univ Cape Town, Dept Med, HIV Med, ZA-7925 Cape Town, South Africa

来源：

AIDS | 2010年 / 24卷 / 03期

基金：

英国惠康基金;

关键词：

arachnoid granulation; cerebrospinal fluid pressure; cryptococcal meningitis; cryptococcus; histopathology; HIV; raised intracranial pressure; INCREASED INTRACRANIAL-PRESSURE; PRACTICE GUIDELINES; VILLI; MANAGEMENT; MENINGOENCEPHALITIS; NEOFORMANS; OUTFLOW; DISEASE; BURDEN; MODEL;

D O I：

10.1097/QAD.0b013e328333c005

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: To investigate the histopathology of the arachnoid granulations in patients with HIV-associated cryptococcal meningitis and correlate the findings with clinical data, in particular cerebrospinal fluid (CSF) opening pressure. Design: Case series. Methods: Postmortems were requested on patients dying during initial hospitalization with HIV-associated cryptococcal meningitis. Results: Five postmortems were performed. Large numbers of cryptococcal cells were seen within the arachnoid granulations. The number of fungal cells correlated with CSF pressure. inflammatory cell infiltrates and disruption of the normal architecture of the granulations were also observed. Conclusion: The study provides the first direct evidence supporting the obstruction to CSF reabsorption at the level of the arachnoid granulations as the main mechanism underlying the development of raised CSF pressure in HIV-associated cryptococcal meningitis. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

引用

页码：405 / 410

页数：6

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