AlHaj Houssen Ahmad, Algreeshah Fahad
Departmentof Neurosurgery, National Care Hospital, Riyadh, Kingdom of Saudi Arabia. E-mail:
Neurosciences (Riyadh). 2018 Apr;23(2):148-151. doi: 10.17712/nsj.2018.2.20170368.
This is a case of a 33-year-old male complaining of severe headache, neck pain, photophobia, vomiting and high-grade fever of several days. He had history of nasal polyp removal and recurrent sinusitis in the last 8 years. On examination: conscious with glasco coma scale (GCS) 15/15 and normal limbs strength but with positive Babinski sign. For further observation, he was admitted and full work-up was done. Even though full empirical antibiotics were started, there was no immediate improvement and he deteriorated dramatically developing ocular deficit, hydrocephalus and lower level of consciousness with multiple infarctions found at different areas in brain. After that point, a decompressive craniectomy was done, and multiple antibiotics and antifungal medications were prescribed. However, he deteriorated to GCS 3/15; cardiopulmonary resuscitations were not successful, as he demised next day. It shall be noted that aspergillosis can lead to difficult complications, so diagnosis and treatments should not be delayed.
这是一例33岁男性患者，主诉数天来严重头痛、颈部疼痛、畏光、呕吐及高热。他在过去8年中有鼻息肉切除及复发性鼻窦炎病史。检查：意识清醒，格拉斯哥昏迷量表（GCS）评分为15/15，四肢肌力正常，但巴氏征阳性。为进一步观察，他被收治入院并进行了全面检查。尽管开始了经验性的足量抗生素治疗，但病情并无立即改善，反而急剧恶化，出现了眼部功能缺损、脑积水以及意识水平下降，脑部不同区域发现多处梗死。此后，进行了减压颅骨切除术，并开具了多种抗生素和抗真菌药物。然而，他的格拉斯哥昏迷量表评分降至3/15；心肺复苏未成功，于次日死亡。应当注意的是，曲霉病可导致棘手的并发症，因此诊断和治疗不应延迟。
