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异基因外周血干细胞移植受者的脑弓形虫病:病例报告及文献复习

Cerebral toxoplasmosis in an allogeneic peripheral stem cell transplant recipient: case report and review of literature.

作者信息

Cibickova L, Horacek J, Prasil P, Slovacek L, Kohout A, Cerovsky V, Hobza V

机构信息

2nd Department of Medicine, Charles University in Prague, Faculty of Medicine in Hradec Kralove and University Hospital in Hradec Kralove, Czech Republic.

出版信息

Transpl Infect Dis. 2007 Dec;9(4):332-5. doi: 10.1111/j.1399-3062.2007.00224.x. Epub 2007 Apr 11.

Abstract

We present a patient who underwent allogeneic peripheral stem cell transplantation (PSCT) for chronic myelocytic leukemia. Twenty months after the PSCT he experienced status epilepticus. Magnetic resonance imaging (MRI) revealed a focus in the ventral thalamus-hypothalamus region. Using stereotactic biopsy with histology and specific polymerase chain reaction investigation from brain tissue, cerebral toxoplasmosis was diagnosed and treated with antiparasitic therapy. Early recognition of such serious and potentially lethal disease enabled prompt specific treatment. This case report emphasizes the role of stereotactic biopsy in diagnosis of cerebral toxoplasmosis. Other methods such as MRI are non-invasive but not sufficiently specific and sensitive.

摘要

我们报告一名因慢性粒细胞白血病接受异基因外周血干细胞移植(PSCT)的患者。PSCT 后 20 个月,他发生了癫痫持续状态。磁共振成像(MRI)显示腹侧丘脑 - 下丘脑区域有一个病灶。通过对脑组织进行立体定向活检及组织学检查和特异性聚合酶链反应研究,诊断为脑弓形虫病,并接受了抗寄生虫治疗。对这种严重且可能致命疾病的早期识别使得能够及时进行特异性治疗。本病例报告强调了立体定向活检在脑弓形虫病诊断中的作用。其他方法如 MRI 是非侵入性的,但特异性和敏感性不足。

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