Kasantikul V, Lerdlum S, Suwanwela N
Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 1992 Sep;75(9):536-41.
Two cases of cerebral abscesses caused by Pseudomonas pseudomallei are reported. The first case, a 51-year-old women had a sudden onset of progressive right hemiparesis and right facial palsy and died within 7 days. Postmortem examination disclosed brain abscess in association with disseminated infection outside the central nervous system. The second case, a 9-year-old boy displayed cerebral abscesses as an isolated manifestation. Recovery occurred after treatment with ceftazidime. Review of the ten case reports of cerebral melioidosis revealed that the lesion occurred in patients of all ages and was more common in men than in women. The frontoparietal lobe was the most common location. Fever, headache, and hemiparesis were frequent clinical manifestations while seizures, ataxia were uncommon. CT scanning, serum antibody titer along with hemoculture were useful investigate tools. The importance of early diagnosis and prompt treatment is emphasized for this fatal but treatable disease.
报告了2例由类鼻疽杆菌引起的脑脓肿病例。首例病例为一名51岁女性,突然出现进行性右侧偏瘫和右侧面瘫,并在7天内死亡。尸检发现脑脓肿并伴有中枢神经系统外的播散性感染。第二例病例为一名9岁男孩,脑脓肿为唯一表现。使用头孢他啶治疗后康复。对10例类鼻疽脑病例报告的回顾显示,病变发生在各年龄段患者中,男性比女性更常见。额顶叶是最常见的部位。发热、头痛和偏瘫是常见的临床表现,而癫痫发作、共济失调则不常见。CT扫描、血清抗体滴度以及血培养是有用的检查工具。对于这种致命但可治疗的疾病,强调早期诊断和及时治疗的重要性。