Department of Encephalopathy and Psychology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
The Fourth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Shenzhen, China.
J Int Med Res. 2022 Nov;50(11):3000605221137470. doi: 10.1177/03000605221137470.
We present the cases of two otherwise healthy adults, one with meningitis and another with a subdural abscess, with both conditions attributable to . A 31-year-old man was admitted with a 3-day history of fever, headache, and vomiting. Physical examination revealed intermittent confusion, irritability, and neck stiffness. Cerebrospinal fluid (CSF) culture was positive for . Contrast-enhanced magnetic resonance imaging (C-MRI) revealed multiple small lesions on the bilateral frontal lobes. Intravenous ceftriaxone and vancomycin were administered, followed by intravenous moxifloxacin. His symptoms resolved within 3 months. Additionally, a 66-year-old man was admitted for acute fever with confusion, abnormal behavior, and a recent history of acute respiratory infection. Physical examination revealed confusion, neck stiffness, and a positive right Babinski sign. CSF metagenomic analysis detected . C-MRI disclosed left occipitotemporal meningoencephalitis with subdural abscesses. Intravenous ceftriaxone was administered for 3 weeks. His condition gradually improved, with resorbed lesions detected on repeat MRI. This study expanded the clinical and imaging spectra of meningitis. In healthy adults, can invade the brain, but subdural abscess is a rare neuroimaging manifestation. Early diagnosis of meningitis by high-throughput sequencing and flexible treatment strategies are necessary for satisfactory outcomes.
我们报告了两例健康成年人的病例，一例患有脑膜炎，另一例患有硬膜下脓肿，这两种情况均归因于 感染。一名 31 岁男性因发热、头痛和呕吐 3 天而入院。体格检查显示间歇性意识混乱、烦躁不安和颈项强直。脑脊液（CSF）培养阳性为 。对比增强磁共振成像（C-MRI）显示双侧额叶有多个小病变。静脉注射头孢曲松和万古霉素，随后静脉注射莫西沙星。他的症状在 3 个月内得到缓解。此外，一名 66 岁男性因急性发热、意识混乱、异常行为和近期急性呼吸道感染而入院。体格检查显示意识混乱、颈项强直和右侧巴氏征阳性。CSF 宏基因组分析检测到 。C-MRI 显示左枕颞脑膜脑炎伴硬膜下脓肿。静脉注射头孢曲松 3 周。他的病情逐渐好转，重复 MRI 检查显示病变吸收。本研究扩展了 脑膜炎的临床和影像学谱。在健康成年人中， 可以侵犯大脑，但硬膜下脓肿是一种罕见的神经影像学表现。通过高通量测序进行早期诊断和灵活的治疗策略对于获得满意的结果是必要的。
