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创伤后5年出现的迟发性脑脊液鼻漏,表现为致死性急性细菌性脑膜炎。

Delayed CSF rhinorrhea presenting as a lethal acute bacterial meningitis 5 years post trauma.

作者信息

Karki Bipin, Acharya Utsav, Pun Bishika, Shrestha Pramesh Sunder

机构信息

Department of Critical Care Medicine, Maharajgunj Medical Campus Institute of Medicine Kathmandu Nepal.

Department of Anaesthesia, Maharajgunj Medical Campus Institute of Medicine Kathmandu Nepal.

出版信息

Clin Case Rep. 2023 May 9;11(5):e7320. doi: 10.1002/ccr3.7320. eCollection 2023 May.

DOI:10.1002/ccr3.7320
PMID:37180318
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10167611/
Abstract

KEY CLINICAL MESSAGE

Delayed presentation of cerebrospinal fluid rhinorrhea is rare following head trauma. It is frequently complicated by meningitis if not addressed in time. This report highlights the importance of its timely management, the lack of which can lead to a fatal outcome.

ABSTRACT

A 33-year-old man presented with meningitis in septic shock. He had a history of severe traumatic brain injury 5 years back following which he had a history of intermittent nasal discharge for the past 1 year. On investigation, he was found to have meningitis, and CT scan of his head showed defects in the cribriform plate which established the diagnosis of meningoencephalitis secondary to cerebrospinal fluid rhinorrhea. The patient did not survive despite appropriate antibiotics.

摘要

关键临床信息

头部外伤后迟发性脑脊液鼻漏罕见。若不及时处理,常并发脑膜炎。本报告强调了及时处理的重要性,否则可能导致致命后果。

摘要

一名33岁男性因感染性休克伴脑膜炎就诊。他5年前有严重颅脑外伤史,此后1年来有间歇性鼻漏病史。经检查,发现他患有脑膜炎,头部CT扫描显示筛板缺损,确诊为脑脊液鼻漏继发的脑膜脑炎。尽管使用了适当的抗生素,患者仍未存活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda8/10167611/c2aacd420e02/CCR3-11-e7320-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda8/10167611/2239353ebce2/CCR3-11-e7320-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda8/10167611/4a71815842c3/CCR3-11-e7320-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda8/10167611/c2aacd420e02/CCR3-11-e7320-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda8/10167611/2239353ebce2/CCR3-11-e7320-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda8/10167611/4a71815842c3/CCR3-11-e7320-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda8/10167611/c2aacd420e02/CCR3-11-e7320-g001.jpg

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本文引用的文献

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A Clinical Case of Delayed Posttraumatic Frontal Sinus Cerebrospinal Fluid Leakage Management Via External Surgical Approach.1例通过外部手术方法延迟处理创伤后额窦脑脊液漏的临床病例
J Craniofac Surg. 2022 Oct 1;33(7):2203-2205. doi: 10.1097/SCS.0000000000008493. Epub 2022 Feb 2.
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Recurrent Community-Acquired Bacterial Meningitis in Adults.成人复发性社区获得性细菌性脑膜炎。
Clin Infect Dis. 2021 Nov 2;73(9):e2545-e2551. doi: 10.1093/cid/ciaa1623.
3
Delay Posttraumatic Paradoxical Cerebrospinal Fluid Leak with Recurrent Meningitis.
创伤后迟发性脑脊液漏伴复发性脑膜炎
Asian J Neurosurg. 2019 Jul-Sep;14(3):964-966. doi: 10.4103/ajns.AJNS_95_18.
4
Delayed Cerebrospinal Fluid Leakage After Treatment of Skull Base Tumors: Case Series of 9 Patients.颅底肿瘤治疗后发生延迟性脑脊液漏:9 例患者的病例系列研究。
World Neurosurg. 2019 Dec;132:e591-e598. doi: 10.1016/j.wneu.2019.08.067. Epub 2019 Aug 20.
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Delayed Diagnosis and Treatment of Cerebrospinal Fluid Leakage in Current Practice.当前临床实践中脑脊液漏的延迟诊断与治疗
J Craniofac Surg. 2019 Sep;30(6):1657-1661. doi: 10.1097/SCS.0000000000005402.
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Delayed presentation of traumatic cerebrospinal fluid rhinorrhea: Case report and literature review.创伤性脑脊液鼻漏的延迟表现:病例报告与文献综述
Allergy Rhinol (Providence). 2015 Jan;6(3):188-90. doi: 10.2500/ar.2015.6.0132.
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