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一名幼儿感染性嗜酸性粒细胞性脑膜脑炎的快速治疗反应

Rapid Therapeutic Response of Eosinophilic Meningoencephalitis in a Toddler With Infection.

作者信息

Muganda Grace N, Akagi Naomi E, Fagbemi Olufisayo D, Chusid Michael J, Nelson Anika M

机构信息

Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.

Medical College of Wisconsin, Milwaukee, Wisconsin.

出版信息

WMJ. 2018 Aug;117(3):130-132.

Abstract

INTRODUCTION

Eosinophilic meningitis is an infrequently encountered condition. (raccoon roundworm) infection, rarely diagnosed in North America, is a known cause of eosinophilic meningitis, often producing death or permanent neurologic damage.

CASE REPORT

We recently encountered a toddler with geophagia and probable exposure to raccoon feces, who presented with eosinophilic meningitis and encephalitis, and was diagnosed with infection and possible Toxocara co-infection. His marked peripheral eosinophilia and neurologic symptoms rapidly responded to corticosteroid and albendazole therapy.

DISCUSSION

Since infection is infrequently encountered, its diagnosis in the proper clinical and epidemiologic setting may not always be considered, resulting in a delay of appropriate therapy. Our patient, diagnosed and treated early in his course, demonstrated rapid clinical and laboratory improvement with anti-inflammatory and antiparasitic therapy.

CONCLUSION

In cases of eosinophilic meningitis, infection with should be routinely considered to allow timely institution of effective therapy for this unusual but potentially fatal or debilitating infection.

摘要

引言

嗜酸性粒细胞性脑膜炎是一种罕见病症。(浣熊蛔虫)感染在北美很少被诊断出来,是已知的嗜酸性粒细胞性脑膜炎病因,常导致死亡或永久性神经损伤。

病例报告

我们最近遇到一名有食土癖且可能接触过浣熊粪便的幼儿,他出现了嗜酸性粒细胞性脑膜炎和脑炎,并被诊断为感染以及可能的弓蛔虫共感染。他显著的外周嗜酸性粒细胞增多和神经症状对皮质类固醇和阿苯达唑治疗反应迅速。

讨论

由于感染很少见,在适当的临床和流行病学背景下可能并不总是会考虑到其诊断,从而导致适当治疗的延迟。我们的患者在病程早期就得到诊断和治疗,抗炎和抗寄生虫治疗使其临床和实验室指标迅速改善。

结论

在嗜酸性粒细胞性脑膜炎病例中,应常规考虑感染,以便及时对这种不寻常但可能致命或使人衰弱的感染采取有效的治疗措施。

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