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经重复腰椎穿刺诊断为无菌性脑膜炎伴孤立性阳性眼球压迫征

Aseptic Meningitis With an Isolated Positive Ocular Globe Compression Sign Diagnosed by Repeat Lumbar Puncture.

作者信息

Mine Yuichiro, Miyagami Taiju, Furuya Satoshi, Kondo Yusuke, Naito Toshio

机构信息

Clinical Training Center, Juntendo University Hospital, Tokyo, JPN.

Department of General Medicine, Juntendo University Hospital, Tokyo, JPN.

出版信息

Cureus. 2022 Nov 30;14(11):e32036. doi: 10.7759/cureus.32036. eCollection 2022 Nov.

Abstract

Aseptic meningitis is diagnosed using clinical and laboratory findings of meningeal inflammation in the absence of bacteria in cerebrospinal fluid smear and culture. It is commonly caused by a viral infection, and most cases are improved without specific treatment. We present a case of aseptic meningitis in a 33-year-old Japanese man that was diagnosed only after a repeat lumbar puncture. The patient had a positive ocular globe compression sign with no other positive meningeal signs. This case highlights the importance of repeated lumbar puncture in patients with suspected aseptic meningitis if the initial lumbar puncture results are negative, and there is a clinical value in assessing the ocular globe compression sign, particularly when other clinical signs of meningitis are absent.

摘要

无菌性脑膜炎是根据脑脊液涂片和培养中无细菌存在,同时结合脑膜炎症的临床及实验室检查结果来诊断的。它通常由病毒感染引起,大多数病例无需特殊治疗即可好转。我们报告一例33岁日本男性无菌性脑膜炎病例,该病例仅在重复腰椎穿刺后才得以确诊。患者有阳性的压眼球征,而无其他阳性脑膜刺激征。该病例强调了对于疑似无菌性脑膜炎患者,若初次腰椎穿刺结果为阴性时重复腰椎穿刺的重要性,并且评估压眼球征具有临床价值,尤其是在没有其他脑膜炎临床体征的情况下。

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本文引用的文献

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