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与耐甲氧西林金黄色葡萄球菌败血症相关的过敏性紫癜性卒中:一例报告及文献复习

Stroke in Henoch-Schönlein purpura associated with methicillin-resistant Staphylococcus aureus septicemia: report of a case and review of the literature.

作者信息

Temkiatvises Kanya, Nilanont Yongchai, Poungvarin Niphon

机构信息

Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2008 Aug;91(8):1296-301.

Abstract

Neurological involvement in Henoch-SchOnlein purpura (HSP) such as stroke is uncommon manifestiation, particularly in association with Staphylococcus aureus (S. aureus). The authors reported a 17-year-old man who developed sudden onset of right hemiparesis while he was admitted in the hospital about his prolonged fever, palpable purpura and upper gastrointestinal bleeding. He also had evidence of MRSA septicemia before the onset of right hemiparesis. Skin biopsy was done and showed that there was leukocytoclastic vasculitis with IgA deposition. He had received completed course of antibiotics and then he was subsequently improved after steroid therapy in the next 2 weeks. Review of case reports from previous English literatures, discovered the association between MRSA infection and HSP which can cause several CNS manifestations including stroke symptoms from cerebral vasculitis.

摘要

过敏性紫癜(HSP)累及神经系统如中风是一种罕见的表现,尤其是与金黄色葡萄球菌(金葡菌)相关时。作者报告了一名17岁男性,因长期发热、可触及的紫癜和上消化道出血入院期间突然出现右侧偏瘫。在右侧偏瘫发作前,他也有耐甲氧西林金黄色葡萄球菌败血症的证据。进行了皮肤活检,显示有白细胞破碎性血管炎伴IgA沉积。他接受了完整疗程的抗生素治疗,随后在接下来的2周内接受类固醇治疗后病情好转。回顾以前英文文献中的病例报告,发现耐甲氧西林金黄色葡萄球菌感染与过敏性紫癜之间存在关联,这可导致包括脑血管炎引起的中风症状在内的几种中枢神经系统表现。

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