鲍曼不动杆菌肺炎后加重的抗N-甲基-D-天冬氨酸受体脑炎：一例报告。

Anti-N-methyl-D-aspartate receptor encephalitis that aggravates after acinetobacter baumannii pneumonia: A case report.

作者信息

Wang Cheng C, Li Da J, Xia Yi Q, Liu Kai

机构信息

Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

Emergency Department, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

出版信息

World J Clin Cases. 2017 Sep 16;5(9):368-372. doi: 10.12998/wjcc.v5.i9.368.

DOI:10.12998/wjcc.v5.i9.368

PMID:29026836

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5618116/

Abstract

We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis (ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed severe status epilepticus and decreased level of conscience with new hyperpyrexia and dyspnea, and was admitted to the emergency intensive care unit. Acinetobacter baumanii were found in the sputum culture; and anti-NMDAR antibodies were positive (titer: 1/80) in the cerebrospinal fluid. Repeated immunotherapy was administered with antibacterial agents, and the patient recovered except for mild psychiatric sequelae. This is the first report of ANMDARE that aggravates after acinetobacter baumannii pneumonia. Awareness and knowledge of this disorder should be extended, especially in the emergency medicine community.

摘要

我们报告了一例非典型抗 N-甲基-D-天冬氨酸受体脑炎（ANMDARE）病例。一名 27 岁被诊断为 ANMDARE 的男性接受了免疫治疗并恢复良好。然而，在一个月内，他出现了严重的癫痫持续状态，意识水平下降，伴有新的高热和呼吸困难，随后被收入急诊重症监护病房。痰培养发现鲍曼不动杆菌；脑脊液中抗 NMDAR 抗体呈阳性（滴度：1/80）。给予重复免疫治疗并使用抗菌药物，患者康复，仅遗留轻度精神后遗症。这是第一例鲍曼不动杆菌肺炎后病情加重的 ANMDARE 报告。应提高对这种疾病的认识和了解，尤其是在急诊医学界。