Chang Kuo-Hsuan, Tang Lok-Ming, Lyu Rong-Kuo
Section of Neuromuscular Diseases, Department of Neurology, Chang Gung Memorial Hospital and University Medical College, Taipei, Taiwan.
J Formos Med Assoc. 2006 Sep;105(9):756-9. doi: 10.1016/S0929-6646(09)60204-7.
Spontaneous Escherichia coli meningitis has not been previously reported in association with hemophagocytic lymphohistiocytosis (HLH). A previously healthy 72-year-old woman was admitted due to fever, nuchal rigidity, disturbed consciousness and splenomegaly. Anemia, thrombocytopenia and hyperferritinemia developed on the 8th day of hospitalization. Cultures of cerebrospinal fluid and blood grew E. coli. Abundant macrophages overwhelmed erythrocytes in the bone marrow aspirate, confirming the presence of hemophagocytosis. E. coli meningitis was managed with a 40-day course of antibiotic treatment. However, the severity of anemia and thrombocytopenia progressed despite intensive transfusion therapy. The patient died of HLH on the 60th day of hospitalization.
自发性大肠杆菌脑膜炎此前尚未见与噬血细胞性淋巴组织细胞增生症（HLH）相关的报道。一名既往健康的72岁女性因发热、颈项强直、意识障碍和脾肿大入院。住院第8天出现贫血、血小板减少和高铁蛋白血症。脑脊液和血液培养均生长出大肠杆菌。骨髓穿刺涂片中可见大量巨噬细胞吞噬红细胞，证实存在噬血细胞现象。大肠杆菌脑膜炎采用了40天疗程的抗生素治疗。然而，尽管进行了强化输血治疗，贫血和血小板减少的严重程度仍不断进展。患者于住院第60天死于HLH。
