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一名患有B型病毒性肝炎和偶发性神经鞘瘤的成人的沙门氏菌脑膜炎。

Salmonella meningitis in an adult with type B viral hepatitis and an incidental schwannoma.

作者信息

Al-Aani Fuad Khalil, Abusalah Salem, Al-Aqeedi Rafid, Ibrahim Abdulsalam

机构信息

Hamad Medical Corporation, Doha, Qatar.

出版信息

BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.11.2008.1209. Epub 2009 May 18.

Abstract

Salmonella meningitis is an unusual complication of Salmonella sepsis that occurs almost exclusively in infants and young children. Cases that do occur in adults are associated with a high morbidity and mortality. The present study concerns a rare case of Salmonella meningitis, the first to be reported in Qatar, in a previously healthy young adult man who was admitted with fever, headache and nuchal rigidity. Cerebrospinal fluid (CSF) culture produced Salmonella paratyphi A, although cultures of blood were negative. The patient was admitted to the medical intensive care unit (MICU) and assisted with mechanical ventilation for 1 week, then transferred to the medical ward where he exhibited progressive improvement on treatment with meropenam for 3 weeks. The patient was found to have an incidental schwannoma causing right-sided hydronephrosis, and hydroureter, treated with double J stent insertion. He was discharged in good condition without any neurological sequelae.

摘要

沙门氏菌脑膜炎是沙门氏菌败血症的一种罕见并发症,几乎仅发生于婴幼儿。在成人中发生的病例与高发病率和高死亡率相关。本研究涉及一例罕见的沙门氏菌脑膜炎病例,这是卡塔尔报告的首例,患者为一名此前健康的年轻成年男性,因发热、头痛和颈部强直入院。脑脊液(CSF)培养出甲型副伤寒沙门氏菌,尽管血培养结果为阴性。患者被收入医疗重症监护病房(MICU),接受了1周的机械通气辅助治疗,随后转至内科病房,在接受美罗培南治疗3周后病情逐渐好转。该患者被发现患有一个偶然发生的神经鞘瘤,导致右侧肾积水和输尿管积水,通过插入双J支架进行治疗。他康复出院,未留下任何神经后遗症。

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