Özel C, Dafotakis M, Nikoubashman O, Litmathe J, Matz O, Schöne U
Neurologische Klinik, RWTH Aachen.
Klinik für Neuroradiologie, RWTH Aachen.
Fortschr Neurol Psychiatr. 2015 Jul;83(7):392-6. doi: 10.1055/s-0035-1553233. Epub 2015 Jul 22.
In clinical practice, secondary infections of the central nervous system (CNS) represent rare yet severe complications of their respective primary infections. In this case report, we describe a 22-year-old patient with a medical history of Asthma bronchiale, who developed significant neurological deficits after a respiratory infection. The neurological symptoms progressed despite antibiotic therapy with vancomycin, ampicillin and ceftriaxone. The patient's cerebrospinal fluid and a cranial magnetic resonance imaging (MRI) furnished evidence of acute meningoencephalitis. Microbiological assessment confirmed an acute mycoplasma pneumonia infection. Changing the patient's antibiotic regimen to minocycline and prednisolone led to significant clinical improvement. Pathomechanisms and therapeutic options to treat meningoencephalitis will be discussed in the following.
在临床实践中,中枢神经系统(CNS)的继发性感染是其各自原发性感染罕见但严重的并发症。在本病例报告中,我们描述了一名有支气管哮喘病史的22岁患者,其在呼吸道感染后出现了明显的神经功能缺损。尽管使用万古霉素、氨苄西林和头孢曲松进行了抗生素治疗,神经症状仍在进展。患者的脑脊液和头颅磁共振成像(MRI)提供了急性脑膜脑炎的证据。微生物学评估证实为急性支原体肺炎感染。将患者的抗生素治疗方案改为米诺环素和泼尼松龙后,临床症状有了显著改善。以下将讨论治疗脑膜脑炎的发病机制和治疗选择。