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[合并脑积水的脑脊膜皮下蝇蛆病。核磁共振成像的价值]

[Neuromeningeal hypodermyiasis complicated by hydrocephaly. Value of nuclear magnetic resonance imaging].

作者信息

François P, Martin G, Goullier A, Plasse M, Beaudoing A

出版信息

Presse Med. 1987 Jun 27;16(25):1231-3.

PMID:2955374
Abstract

A 9-year old country boy developed blepharitis with inflammation of the face and, 1 month later, eosinophilic meningitis with paralysis of 3 limbs and of an abducent nerve. Nuclear magnetic resonance imaging of the central nervous system disclosed a lesional signal beneath the floor of the 4th ventricle, which was compatible with the presence of a larva of fly. Treatment with thiabendazole was tried, and the clinical signs regressed. Six months later, an asymmetrical hydrocephalus due to obstruction of Monroe's foramen by an inflammatory granuloma was discovered. Human hypodermyasis, due to migration in tissues of larvae of flies, is not rare in cattle-breeding areas. Neuromeningeal disorders are observed in 12% of the cases, consisting of eosinophilic meningitis sometimes associated with neurological deficit or seizures. Such complications as intracerebral haematoma or meningeal haemorrhage may occur during the usually benign course of the disease.

摘要

一名9岁的农村男孩患上了睑缘炎并伴有面部炎症,1个月后又出现嗜酸性粒细胞性脑膜炎,伴有三肢及展神经麻痹。中枢神经系统的核磁共振成像显示第四脑室底部下方有一个病变信号,这与存在蝇幼虫相符。尝试使用噻苯达唑进行治疗,临床症状消退。6个月后,发现由于炎性肉芽肿阻塞孟氏孔导致不对称性脑积水。在畜牧地区,由于蝇幼虫在组织中移行引起的人体皮下蝇蛆病并不罕见。在12%的病例中观察到神经脑膜疾病,包括有时伴有神经功能缺损或癫痫发作的嗜酸性粒细胞性脑膜炎。在这种通常为良性病程的疾病中,可能会发生诸如脑内血肿或脑膜出血等并发症。

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