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社区获得性脑膜炎并发化脓性脑室炎:一例报告

Community-Acquired Meningitis Complicated by Pyogenic Ventriculitis: A Case Report.

作者信息

Adhikari Pabitra, Antala Drashti, Pyakuryal Bimatshu, Muhammed Ahmed, Pudasainee Prasun, Friedman Harvey, Ezepue Chizoba J

机构信息

Internal Medicine, AMITA Health Saint Francis Hospital, Evanston, USA.

Critical Care, AMITA Health Saint Francis Hospital, Evanston, USA.

出版信息

Cureus. 2022 Apr 7;14(4):e23907. doi: 10.7759/cureus.23907. eCollection 2022 Apr.

Abstract

Ventriculitis is the inflammation of the ependymal lining of the ventricles in the brain which usually occurs as a complication of meningitis, intraventricular devices, intracranial surgery, or brain abscess. Common clinical features include fever, altered mental status, headache, and neck rigidity. Some commonly associated organisms are gram-negative , , and Here, we report the case of a 57-year-old female presenting with fever, headache, and altered mental status, along with positive physical examination findings of Kernig's and Brudzinski's signs without any focal neurological deficits. Cerebrospinal fluid analysis findings were consistent with bacterial infection with neutrophilic leukocytosis, high protein, and low glucose. The blood culture was positive for . Magnetic resonance imaging was negative for enhancement of the meninges but showed fluid-filled layering in the ventricles consistent with pyogenic ventriculitis. The patient improved clinically within three days of initiation of empiric antibiotics.

摘要

脑室炎是指脑室内室管膜衬里的炎症,通常作为脑膜炎、脑室内装置、颅内手术或脑脓肿的并发症出现。常见临床特征包括发热、精神状态改变、头痛和颈部强直。一些常见的相关病原体为革兰氏阴性菌等。在此,我们报告一例57岁女性病例,该患者出现发热、头痛和精神状态改变,体格检查发现凯尔尼格征和布鲁津斯基征呈阳性,且无任何局灶性神经功能缺损。脑脊液分析结果符合细菌感染,表现为中性粒细胞增多、蛋白升高和葡萄糖降低。血培养结果显示[具体细菌名称]呈阳性。磁共振成像显示脑膜无强化,但脑室中有液性分层,符合化脓性脑室炎表现。患者在经验性使用抗生素治疗三天内临床症状有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cb8/9077952/f9b57b7140e9/cureus-0014-00000023907-i01.jpg

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