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病例报告:一例免疫功能正常患者在侵入性手术后发生脑膜脑炎的病例。

Case Report: A Case of Meningoencephalitis in an Immunocompetent Patient After Invasive Operation.

作者信息

Cui Yue, Meng Jiali, Zhang Jing, Wang Lin, Yan Haihan, Xia Han, Cao Jingrong, Wu Liyong

机构信息

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China.

出版信息

Front Med (Lausanne). 2021 Nov 10;8:762763. doi: 10.3389/fmed.2021.762763. eCollection 2021.

Abstract

As an opportunistic phytopathogen, has only been shown to cause neurological disease in immunocompromised patients, where antifungal therapy was not effective. We report a case of meningoencephalitis in an apparently immunocompetent young woman who presented with severe headache and slight fever after undergoing transnasal endoscopic repair of cerebrospinal fluid rhinorrhea. Chronic sinusitis and suspicious intracranial fungal lesions were observed on enhanced magnetic resonance imaging (MRI). Both culture and metagenomic next-generation sequencing of her cerebrospinal fluid were positive for . After local debridement, treatment with amphotericin B plus voriconazole and Ommaya reservoir implantation, the patient improved significantly. Unfortunately, her symptoms worsened again despite plenty of antifungal therapy for a month.

摘要

作为一种机会性植物病原体,仅在免疫功能低下且抗真菌治疗无效的患者中被证明可引起神经系统疾病。我们报告一例明显免疫功能正常的年轻女性发生的[病原体名称]脑膜脑炎病例,该患者在经鼻内镜修复脑脊液鼻漏后出现严重头痛和低热。增强磁共振成像(MRI)显示有慢性鼻窦炎和可疑的颅内真菌病变。她的脑脊液培养和宏基因组下一代测序均显示[病原体名称]呈阳性。经过局部清创、两性霉素B加伏立康唑治疗以及奥马亚贮液器植入后,患者有显著改善。不幸的是,尽管进行了一个月的大量抗真菌治疗,她的症状再次恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/530e/8631361/532ad3b16812/fmed-08-762763-g0001.jpg

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