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1
Ventriculoperitoneal Shunt-Associated Vancomycin-Resistant Meningitis Complicating a Patient Undergoing Plasmapheresis for Presumed Systemic Lupus Erythematosus-Associated Transverse Myelitis.脑室腹腔分流术相关的耐万古霉素脑膜炎,使一名因疑似系统性红斑狼疮相关横贯性脊髓炎而接受血浆置换的患者病情复杂化。
J Neurol Surg Rep. 2017 Oct;78(4):e123-e124. doi: 10.1055/s-0037-1607280. Epub 2017 Nov 3.
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Acute transverse myelopathy complicating systemic lupus erythematosus.并发系统性红斑狼疮的急性横贯性脊髓病
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本文引用的文献

1
Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Writing Committee of the American Society for Apheresis: the sixth special issue.美国血液分离协会写作委员会制定的临床实践中治疗性血液分离术使用指南:循证方法,第六期特刊。
J Clin Apher. 2013 Jul;28(3):145-284. doi: 10.1002/jca.21276.
2
Treatment of meningitis caused by vancomycin-resistant Enterococcus faecium: high-dose and combination daptomycin therapy.治疗万古霉素耐药粪肠球菌引起的脑膜炎:高剂量和联合达托霉素治疗。
Ann Pharmacother. 2010 Dec;44(12):2001-6. doi: 10.1345/aph.1P333. Epub 2010 Nov 30.

脑室腹腔分流术相关的耐万古霉素脑膜炎,使一名因疑似系统性红斑狼疮相关横贯性脊髓炎而接受血浆置换的患者病情复杂化。

Ventriculoperitoneal Shunt-Associated Vancomycin-Resistant Meningitis Complicating a Patient Undergoing Plasmapheresis for Presumed Systemic Lupus Erythematosus-Associated Transverse Myelitis.

作者信息

Covach Adam John, Rose William Nicholas

机构信息

Department of Pathology, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.

出版信息

J Neurol Surg Rep. 2017 Oct;78(4):e123-e124. doi: 10.1055/s-0037-1607280. Epub 2017 Nov 3.

DOI:10.1055/s-0037-1607280
PMID:29109928
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5669984/
Abstract

We report a patient who had a working diagnosis of transverse myelitis secondary to a lupus exacerbation. As his clinical course evolved, continued vigilance clarified that he was in fact suffering from a nosocomial infection caused by vancomycin-resistant (VRE).  We performed a retrospective review of the patient's medical record.  Despite radiographic improvement, he did not improve clinically following immunosuppressive therapy including plasma exchange. Once meningitis was diagnosed and treated, he improved rapidly.  The prospect of transverse myelitis may confound the diagnosis of VRE meningitis, a uniquely treated and potentially deadly infection.

摘要

我们报告了一名初步诊断为狼疮加重继发横贯性脊髓炎的患者。随着其临床病程的发展,持续的密切观察明确了他实际上是感染了耐万古霉素肠球菌(VRE)引起的医院感染。

我们对该患者的病历进行了回顾性分析。

尽管影像学检查有改善,但在包括血浆置换在内的免疫抑制治疗后,他的临床症状并未改善。一旦诊断并治疗了脑膜炎,他的病情迅速好转。

横贯性脊髓炎的情况可能会混淆VRE脑膜炎的诊断,这是一种治疗方式独特且可能致命的感染。