Department of Neurosurgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, Mississippi 39216, USA.
J Clin Neurosci. 2011 Aug;18(8):1118-20. doi: 10.1016/j.jocn.2010.11.033. Epub 2011 Jun 8.
This is the first report to our knowledge of the successful treatment of an asymptomatic mycotic aneurysm associated with Balamuthia mandrillaris encephalitis. A 27-year-old male with end-stage renal disease presented with generalized seizures following renal transplantation. MRI demonstrated multiple brain masses and an aneurysm of the cavernous and supraclinoid carotid artery. Autopsy of the donor's brain revealed Balamuthia encephalitis. The patient was placed on an anti-amebic regimen, his condition improved, and 126 days after the kidney transplant, MRI brain showed resolution of the aneurysm and improvement of the enhancing lesions. Balamuthia mandrillaris has been shown to cause a granulomatous encephalitis, with prominent vasculitis. This is the first report to demonstrate the risk of aneurysm formation associated with this infection. Prolonged anti-amebic treatment resulted in resolution of the aneurysm without clinical evidence of subarachnoid hemorrhage.
这是我们所知的首例成功治疗与巴尔通体属曼氏利什曼原虫脑膜脑炎相关的无症状性真菌性动脉瘤的报告。一名 27 岁男性，在肾移植后出现全身癫痫发作，患有终末期肾病。MRI 显示多个脑肿块和海绵窦及前床突颈动脉的动脉瘤。供体大脑的尸检显示巴尔通体属脑膜脑炎。患者接受抗阿米巴治疗，病情改善，在肾移植后 126 天，MRI 脑部显示动脉瘤消退，增强病变改善。巴尔通体属已被证明可引起肉芽肿性脑膜脑炎，伴有明显的血管炎。这是首例报告显示这种感染与动脉瘤形成的风险相关。延长的抗阿米巴治疗导致动脉瘤消退，没有蛛网膜下腔出血的临床证据。
