Barr Luke K, Sharer Leroy R, Khadka Kunwar Erina, Kapila Rajendra, Zaki Sherif R, Drew Clifton P, Bhatnagar Julu, Liu James K, Chew Debra
Department of Neurological Surgery, Rutgers New Jersey Medical School, Suite 8100, 90 Bergen Street, Newark, NJ 07103, USA.
Department of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
J Clin Neurosci. 2015 Jun;22(6):1057-60. doi: 10.1016/j.jocn.2014.11.036. Epub 2015 Mar 25.
We report a rare case of Mycobacterium haemophilum presenting as an intraventricular granulomatous mass with loculated hydrocephalus and seizures in a patient with human immunodeficiency virus. M. haemophilum, a slow-growing mycobacteria, causes localized and disseminated disease among immunocompromised hosts. Central nervous system infection with M. haemophilum is extremely rare. Preoperative laboratory testing of our patient for tuberculosis, toxoplasmosis, sarcoidosis and histoplasmosis were negative. Surgical resection of the mass revealed a caseating granuloma that stained positive for acid-fast bacillus suggesting possible tuberculoma. Despite negative testing for tuberculosis, a polymerase chain reaction analysis was ultimately performed from the resected mass which revealed M. haemophilum. To our knowledge, this is the first case of M. haemophilum presenting as an intraventricular mass. We review the clinical manifestations of this pathogen and discuss the medical and surgical management.
我们报告了一例罕见的嗜血性分枝杆菌病例，该病例表现为一名人类免疫缺陷病毒患者的脑室内肉芽肿性肿块，并伴有局限性脑积水和癫痫发作。嗜血性分枝杆菌是一种生长缓慢的分枝杆菌，可在免疫功能低下的宿主中引起局部和播散性疾病。嗜血性分枝杆菌引起的中枢神经系统感染极为罕见。我们的患者术前针对结核、弓形虫病、结节病和组织胞浆菌病的实验室检查均为阴性。对肿块进行手术切除后发现一个干酪样肉芽肿，抗酸杆菌染色呈阳性，提示可能为结核瘤。尽管结核检测呈阴性，但最终对切除肿块进行了聚合酶链反应分析，结果显示为嗜血性分枝杆菌。据我们所知，这是首例嗜血性分枝杆菌表现为脑室内肿块的病例。我们回顾了这种病原体的临床表现，并讨论了药物和手术治疗方法。
