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急性出血性白质脑炎(AHLE):肺炎支原体罕见的中枢神经系统表现

Acute Hemorrhagic Leucoencephalitis (AHLE): A Rare CNS Presentation of Mycoplasma pneumoniae.

作者信息

Been Sayeed S K Jakaria, Moniruzzaman Md, Mahmud Reaz, Rashid Mohammad B, Chandra Das Subir

机构信息

Medicine and Rheumatology, National Institute of Neurosciences & Hospital, Dhaka, BGD.

Stroke Unit, National Institute of Neurosciences & Hospital, Dhaka, BGD.

出版信息

Cureus. 2022 Oct 31;14(10):e30921. doi: 10.7759/cureus.30921. eCollection 2022 Oct.

Abstract

Acute hemorrhagic leucoencephalitis (AHLE) is a rare inflammatory disease of the brain. Literature on the presentation and management of this rare disease is limited. A  infection is considered a possible trigger for acute hemorrhagic leucoencephalitis (Weston-Hurst syndrome). We report a case of a 58-year-old man presenting with an altered level of consciousness following a history of acute respiratory tract infection. He had also clinical and laboratory features of disseminated intravascular coagulation (DIC). Brain imaging was suggestive of hemorrhagic encephalitis involving both the fronto-temporo-parieto-occipital lobes involving the cortical, subcortical, and splenium of the corpus callosum and the posterior limb of the right internal capsule. Antibodies against Mycoplasma were strongly positive in serum. The patient was treated with fresh frozen plasma, broad-spectrum antibiotics, and methylprednisolone. However, the patient died after 17 days of hospitalization probably due to multiorgan failure and brain herniation.

摘要

急性出血性白质脑炎(AHLE)是一种罕见的脑部炎症性疾病。关于这种罕见疾病的临床表现及治疗的文献有限。一种感染被认为是急性出血性白质脑炎(韦斯顿 - 赫斯特综合征)的可能触发因素。我们报告一例58岁男性病例,该患者在有急性呼吸道感染病史后出现意识水平改变。他还具有弥散性血管内凝血(DIC)的临床和实验室特征。脑部影像学检查提示出血性脑炎,累及额颞顶枕叶,包括皮质、皮质下、胼胝体压部以及右侧内囊后肢。血清中抗支原体抗体呈强阳性。该患者接受了新鲜冷冻血浆、广谱抗生素和甲泼尼龙治疗。然而,患者在住院17天后死亡,可能是由于多器官功能衰竭和脑疝。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c52e/9710724/5f053d605106/cureus-0014-00000030921-i01.jpg

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