Petri William A, Haque Rashidul
Department of Medicine, University of Virginia, Charlottesville, VA, USA.
Handb Clin Neurol. 2013;114:147-52. doi: 10.1016/B978-0-444-53490-3.00009-1.
Brain abscess due to Entamoeba histolytica is most commonly seen in a small percentage of patients who also have an amebic liver abscess. The typical patient is a young man who after treatment for liver abscess with apparent improvement develops symptoms and signs of central nervous system involvement. The average age of the patient is 30 years, and common presentations include headache, vomiting, and altered mental status. Signs of amebic brain abscess include most commonly meningeal signs, facial nerve (VII) palsy, motor paralysis, and seizure. Most patients have abnormal cerebrospinal fluid although there is no special or characteristic abnormality. Diagnosis is by serology and PCR of brain abscess aspirate or CSF and treatment is with metronidazole.
由溶组织内阿米巴引起的脑脓肿最常见于一小部分同时患有阿米巴肝脓肿的患者。典型患者是一名年轻男性，在接受肝脓肿治疗且病情明显改善后，出现中枢神经系统受累的症状和体征。患者的平均年龄为30岁，常见表现包括头痛、呕吐和精神状态改变。阿米巴脑脓肿的体征最常见的是脑膜刺激征、面神经（VII）麻痹、运动性瘫痪和癫痫发作。大多数患者脑脊液异常，尽管没有特殊或特征性异常。诊断依靠脑脓肿抽吸物或脑脊液的血清学检查和聚合酶链反应（PCR），治疗使用甲硝唑。
