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一名肝硬化患者的幕上脑脓肿

Supratentorial Brain Abscess in a Patient with Liver Cirrhosis.

作者信息

Flores-Perez Romulo Omar, Villarreal-Villarreal Cesar Daniel, Garza Jesus Alberto Cardenas-de La, Galarza-Delgado Dionicio Angel

机构信息

Department of Internal Medicine, Autonomous University, Faculty of Medicine and University Hospital Dr. José Eleuterio González, Monterrey, México.

出版信息

Ann Indian Acad Neurol. 2020 Jan-Feb;23(1):107-109. doi: 10.4103/aian.AIAN_233_18.

Abstract

Meningitis and meningoencephalitis account for the majority of central nervous system infections by (). Macroscopic listerial brain abscess is a rare infection. Early recognition of brain abscesses represents a major diagnostic challenge. Mortality from brain abscesses is high but can be reduced when appropriate treatment is timely started. Immunosuppressed patients are more often affected, and a high suspicion is needed for prompt identification. Treatment should be individualized taking into account the comorbidities, lesion size and location, bacterial resistance, and clinical and radiological response. We present a case of a supratentorial brain abscess in a patient with liver cirrhosis whose family denied surgical management, and despite the large size, clinical and radiological success was achieved with 4 weeks of ampicillin.

摘要

脑膜炎和脑膜脑炎占()引起的中枢神经系统感染的大多数。宏观可见的李斯特菌脑脓肿是一种罕见的感染。早期识别脑脓肿是一项重大的诊断挑战。脑脓肿的死亡率很高,但如果及时开始适当治疗则可降低。免疫抑制患者更常受到影响,需要高度怀疑以迅速识别。治疗应个体化,要考虑到合并症、病变大小和位置、细菌耐药性以及临床和放射学反应。我们报告一例肝硬化患者发生幕上脑脓肿的病例,其家属拒绝手术治疗,尽管脓肿体积较大,但使用氨苄西林治疗4周后取得了临床和放射学上的成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09a/7001453/479fc876bd80/AIAN-23-107-g001.jpg

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