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一名73岁患有骨硬膜缺损的女性因[具体病因未给出]导致的脑膜炎。

Meningitis due to in a 73 year old woman with an osteodural defect.

作者信息

Aida Zaghdoudi, Lamia Ammari, Souheil Zayet, Badreddine Kilani, Monika Bukta, Rim Abdelmalek, Aida Berriche, Hajer Harrabi, Hanen Tiouiri Benaissa

机构信息

Department of Infectious Diseases, La Rabta, Tunis, Tunisia.

出版信息

IDCases. 2020 May 13;21:e00779. doi: 10.1016/j.idcr.2020.e00779. eCollection 2020.

Abstract

Meningitis caused by (SE) is a rare disease associated with high rates of complications. Commonly identified risk factors are regular horse contact and consumption of unpasteurized dairy products. When diagnosed promptly, this infection can be cured. We report the case of a 73 year old woman who presented to the hospital with a sudden holocranial headaches, fever, photophobia, sonophobia, vomiting and behavioural disorders. She lived in a rural area and regularly consumed unpasteurized milk products. She had a medical history of osteodural defect, chronic otitis, high blood pressure and pulmonary fibrosis. We suspected bacterial meningitis associated with an ear infection. A lumbar puncture was performed. (SEZ) was discovered in the CSF's culture. Initially, the patient was treated with ceftriaxone. She had a tonic-clonic seizure 2days later. On the cerebral enhanced MRI, we found a right temporal pored cavity adjacent to a tegmen tympani bone breach. The patient received 15 days of antibiotic therapy with a good outcome. However, she was readmitted 24 h after being discharged for the same initial symptomatology. She received a total of 25 days of antibiotics and 4 days of corticoids with good results. Only a few cases of meningitis have been documented. We reported this case to insist on the importance of considering this diagnosis in patients with risk factors. We also point out that severe complications may occur despite the early initiation of adequate treatment.

摘要

由[具体病原体名称未给出,推测是某种特定细菌或病原体,这里用“(SE)”表示]引起的脑膜炎是一种罕见疾病,并发症发生率很高。常见的危险因素是经常接触马匹和食用未经巴氏消毒的乳制品。如果能及时诊断,这种感染是可以治愈的。我们报告一例73岁女性病例,该患者因突发全颅头痛、发热、畏光、畏声、呕吐及行为障碍入院。她生活在农村地区,经常食用未经巴氏消毒的奶制品。她有骨硬膜缺损、慢性中耳炎、高血压和肺纤维化病史。我们怀疑是与耳部感染相关的细菌性脑膜炎。进行了腰椎穿刺。在脑脊液培养中发现了[具体病原体名称未给出,推测是某种特定细菌或病原体,这里用“(SEZ)”表示]。最初,患者接受头孢曲松治疗。2天后她出现了强直阵挛性发作。在脑部增强磁共振成像上,我们发现右侧颞部有一个与鼓室盖骨破损相邻的空洞。患者接受了15天的抗生素治疗,效果良好。然而,出院24小时后她因相同的初始症状再次入院。她总共接受了25天的抗生素治疗和4天的皮质类固醇治疗,效果良好。仅有少数[具体病原体名称未给出,推测是某种特定细菌或病原体,这里用“(SE)”表示]脑膜炎病例有文献记载。我们报告此病例是为了强调在有危险因素的患者中考虑这一诊断的重要性。我们还指出,尽管早期开始了充分治疗,仍可能发生严重并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa4c/7264763/77ace1409e08/gr1.jpg

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