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胎儿弯曲菌定植于海绵状血管畸形并发脑脓肿:病例报告及文献复习。

Campylobacter fetus seeding of a cavernous malformation resulting in brain abscess: case report and literature review.

机构信息

Larner College of Medicine, University of Vermont, Burlington, VT, USA.

Department of Neurosurgery, University of Vermont Medical Center, Burlington, VT, USA.

出版信息

Childs Nerv Syst. 2023 Dec;39(12):3627-3631. doi: 10.1007/s00381-023-06074-0. Epub 2023 Jul 17.

Abstract

Microbial seeding of a cerebral cavernous malformation is an extremely rare occurrence with only 3 cases reported in the literature thus far. Campylobacter fetus is an opportunistic pathogen that rarely causes neurological infection with only 3 cases of C. fetus cerebral abscesses and 38 cases of C. fetus meningitis reported in the literature. There have been no cases of cerebral cavernous malformation seeding by C. fetus reported to date. We report the first case of cerebral cavernous malformation seeding by C. fetus, a case occurring in a previously healthy 16-year-old female who presented with suspected left cerebellar cavernous malformation with subacute hemorrhage. She underwent a suboccipital craniectomy for the resection of the cavernous malformation with additional intraoperative findings suggestive of cerebral abscess. Following positive blood and CSF cultures and surgical pathology results, the patient was diagnosed with C. fetus meningoencephalitis with co-infected left cerebellar cavernous malformation. This is the fourth reported case of microbial seeding of a cerebral cavernous malformation, and to our knowledge, the first case of a C. fetus-infected cavernous malformation. Compared to previous reports, the clinical events of this case strongly support the presence of a preexisting lesion that was secondarily seeded versus de novo formation as a result of prior infection.

摘要

脑海绵状血管畸形的微生物播种是一种极其罕见的现象,迄今为止,文献中仅报道了 3 例。胎儿弯曲菌是一种机会性病原体,很少引起神经感染,文献中仅报道了 3 例胎儿弯曲菌脑脓肿和 38 例胎儿弯曲菌脑膜炎。目前尚无胎儿弯曲菌引起脑海绵状血管畸形播种的病例报告。我们报告首例胎儿弯曲菌引起的脑海绵状血管畸形播种病例,该病例发生在一名既往健康的 16 岁女性,表现为疑似左侧小脑海绵状血管畸形伴亚急性出血。她接受了枕下颅骨切除术切除海绵状血管畸形,术中发现脓肿的额外表现。血液和 CSF 培养及手术病理结果阳性后,患者被诊断为胎儿弯曲菌脑膜脑炎合并左侧小脑海绵状血管畸形合并感染。这是第四例报道的脑海绵状血管畸形微生物播种病例,据我们所知,也是首例胎儿弯曲菌感染的海绵状血管畸形病例。与以往的报告相比,该病例的临床事件强烈支持存在先前存在的病变,病变是继发于先前感染而非新形成的。

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