Poungvarin N, Jariya P
Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1991 Feb;74(2):112-5.
The fifth nonlethal case of primary amoebic meningoencephalitis was reported. He was a 61-year-old gardener from northeast Thailand who had an abrupt onset of high fever, headache and stupor. Lumbar puncture showed numerous naegleria in the cerebrospinal fluid. The combination of 0.5 mg/kg/day of intravenous amphotericin B for 14 days, oral rifampicin and oral ketoconazole for 1 month cured the patient with no recurrence after one year of follow-up. The authors emphasise the regimen of low dose amphotericin B for a prolonged period instead of a high dose over a short period.
第五例原发性阿米巴脑膜脑炎非致死病例被报道。患者是一名来自泰国东北部的61岁园丁,突然出现高热、头痛和昏迷。腰椎穿刺显示脑脊液中有大量耐格里阿米巴原虫。静脉注射两性霉素B,剂量为0.5mg/kg/天,持续14天,同时口服利福平及酮康唑1个月,该患者得以治愈,随访一年无复发。作者强调采用低剂量两性霉素B长期治疗方案,而非短期高剂量治疗方案。