Liu Juan-Fang, Li Yuan, Li Kai, Zhang Xiao, Yang Yi-Ning, Zhao Gang, Liu Zhi-Rong
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China; Department of Clinical Aerospace Medicine, Key Laboratory of Aerospace Medicine of Ministry of Education, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China.
Department of Clinical Medicine, Second Clinical Medical College, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.
Exp Ther Med. 2016 Apr;11(4):1239-1242. doi: 10.3892/etm.2016.3052. Epub 2016 Feb 8.
Neuro-Sweet disease (NSD) is Sweet disease with central nervous system (CNS) involvement. To the best of our knowledge, the present case report is the first to describe NSD complicated by endogenous infection with . The present case report describes a male patient who developed NSD-induced meningitis, which initially manifested as a fever, headache and neck stiffness. Painful erythematous plaques subsequently developed on his face, neck and upper trunk. Brain magnetic resonance imaging was performed and the results were normal, whereas modified acid-fast stain analysis of the cerebrospinal fluid (CSF) provided a positive result. The patient was thus diagnosed with viral meningitis and tuberculosis. However, subsequent skin biopsy results demonstrated neutrophilic infiltration into the dermis without vasculitis, and subsequent human leukocyte antigen typing was positive for Cw1 and negative for B51 and the patient was diagnosed with NSD. Following treatment with corticosteroids, and antiviral and anti-tuberculotic agents, the clinical symptoms were reduced and the previously abnormal findings in the CSF examinations and associated laboratory data were improved. The present case indicates that the diagnosis of NSD is not easily achieved, and early skin biopsy is vital to ensure a fast and effective diagnosis. In addition to systemic corticosteroids, comprehensive treatment is also recommended for patients with NSD complicated by additional complex medical problems.
神经Sweet病（NSD）是伴有中枢神经系统（CNS）受累的Sweet病。据我们所知，本病例报告是首例描述并发 内源性感染的NSD。本病例报告描述了一名男性患者，其发生了NSD诱发的脑膜炎，最初表现为发热、头痛和颈部僵硬。随后其面部、颈部和上躯干出现疼痛性红斑斑块。进行了脑磁共振成像检查，结果正常，而脑脊液（CSF）的改良抗酸染色分析结果呈阳性。因此该患者被诊断为病毒性脑膜炎和结核病。然而，随后的皮肤活检结果显示真皮有嗜中性粒细胞浸润但无血管炎，随后人类白细胞抗原分型显示Cw1阳性，B51阴性，该患者被诊断为NSD。在用皮质类固醇、抗病毒和抗结核药物治疗后，临床症状减轻，CSF检查和相关实验室数据中先前的异常结果得到改善。本病例表明，NSD的诊断不易实现，早期皮肤活检对于确保快速有效的诊断至关重要。除全身用皮质类固醇外，对于并发其他复杂医学问题的NSD患者，也建议进行综合治疗。
