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接受类固醇治疗的系统性红斑狼疮患者因感染导致脑脓肿。

Brain abscess caused by infection in systemic lupus erythematosus patient with steroid therapy.

作者信息

Yagi Ryokichi, Ooi Yukimasa, Nonoguchi Naosuke, Wanibuchi Masahiko

机构信息

Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan.

Department of Infection Control and Prevention, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan.

出版信息

Surg Neurol Int. 2022 Apr 8;13:126. doi: 10.25259/SNI_78_2022. eCollection 2022.

Abstract

BACKGROUND

is an aerobic Gram-negative bacillus belonging to actinomycetes and has been reported to be an infectious disease in healthy individuals. However, more than 60% have some underlying illnesses and are said to be opportunistic infections.

CASE DESCRIPTION

The case was a 69-year-old man who had been on long-term steroids for systemic lupus erythematosus. He developed with nausea and gait disturbance and was suspected of having a brain abscess by imaging. Abscess drainage detects actinomycetes that appear to belong to the genus and brain abscess by using matrix-assisted laser desorption/ionization time-of-flight mass analysis (MALDITOFMS) I was diagnosed. He died during the course of the treatment, and his organs did not detect his at necropsy, so he concluded that bacterial death from long-term administration of antibiotics was the cause of death.

CONCLUSION

is a very rare bacterium belonging to and is said to easily form brain lesions. In immunocompromised patients, prophylaxis with antibiotics and detailed examination of lung lesions for surveillance were considered necessary. This paper is the first report of a brain abscess caused by , including a review of the literature.

摘要

背景

是一种属于放线菌的需氧革兰氏阴性杆菌,据报道在健康个体中可引发感染性疾病。然而,超过60%的患者存在一些基础疾病,被认为是机会性感染。

病例描述

该病例为一名69岁男性,因系统性红斑狼疮长期服用类固醇药物。他出现恶心和步态障碍,经影像学检查怀疑患有脑脓肿。通过脓肿引流检测到似乎属于该属的放线菌,并使用基质辅助激光解吸/电离飞行时间质谱分析(MALDITOFMS)诊断为脑脓肿。他在治疗过程中死亡,尸检时在其器官中未检测到该菌,因此得出结论,长期使用抗生素导致细菌死亡是死因。

结论

是一种非常罕见的属于该属的细菌,据说很容易形成脑部病变。在免疫功能低下的患者中,认为有必要使用抗生素进行预防并对肺部病变进行详细检查以进行监测。本文是由引发脑脓肿的首例报告,包括文献综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b8f/9062894/0b50eb5fed61/SNI-13-126-g001.jpg

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