Paz-Sendín L, González-Torres R, Gámez-Morales L, Hernández-González G
Servicio de Neurología, Hospital Carlos J. Finlay, La Habana, Cuba.
Rev Neurol. 1999;29(9):817-8.
Eosinophilic meningoencephalitis is characterized by a meningeal syndrome and an eosinophilic reaction of the cerebrospinal fluid (CSF). When these symptoms persist for more than four weeks, it is said to be chronic. Both eosinophilic meningoencephalitis and chronic meningoencephalitis are of multiple aetiologies, including fungi.
We report a case in which chronic meningoencephalitis occurred, with persistence of leukocytes, mainly eosinophils, in the CSF. The patient complained of intense, generalized headache and a temperature of 37 degrees C. On physical examination, the only unusual finding was slight neck stiffness. During the clinical course there were focal motor signs and evidence of intracranial hypertension. On CSF culture Candida guillermondii was grown. Treatment with amphotericin B was given, and the neurological disorder remitted completely.
Candida guillermondii may be the etiological agent in chronic eosinophilic meningoencephalitis.
嗜酸性粒细胞性脑膜脑炎的特征为脑膜综合征及脑脊液(CSF)嗜酸性粒细胞反应。当这些症状持续超过四周时,称为慢性嗜酸性粒细胞性脑膜脑炎。嗜酸性粒细胞性脑膜脑炎和慢性脑膜脑炎均有多种病因,包括真菌。
我们报告一例慢性脑膜脑炎病例,脑脊液中白细胞持续存在,主要为嗜酸性粒细胞。患者主诉剧烈头痛且全头部疼痛,体温37摄氏度。体格检查时,唯一异常发现为轻度颈部强直。在病程中出现局灶性运动体征及颅内高压证据。脑脊液培养分离出季也蒙念珠菌。给予两性霉素B治疗,神经功能障碍完全缓解。
季也蒙念珠菌可能是慢性嗜酸性粒细胞性脑膜脑炎的病原体。