General Neurology Division, Albert Einstein Israeli Institute of Education and Research, São Paulo, Brazil.
Research and Development Sector, Clinical Laboratory, Albert Einstein Israeli Institute of Education and Research, São Paulo, Brazil.
Pract Neurol. 2023 Nov 23;23(6):509-511. doi: 10.1136/pn-2023-003795.
A 68-year-old Brazilian woman had 3 months of progressive fatigue, difficulty walking and 18 kg weight loss. On examination, there was gait apraxia and executive dysfunction. MR scan of brain showed communicating hydrocephalus and a cerebrospinal fluid showed 105 white cells/µL (≤5), predominantly lymphocytes, protein of 1.35 g/L (0.15-0.45) and the glucose content of 0.06 mmol/L (3.3-4.4). We suspected an infective cause and used of metagenomic next-generation sequencing to diagnose neurocysticercosis. This case highlights the challenge of diagnosing chronic meningitis and the relevance of genetic approaches in diagnosing neurological infections.
一位 68 岁的巴西女性出现了 3 个月的进行性疲劳、行走困难和 18kg 的体重减轻。体格检查显示步态失用和执行功能障碍。脑部磁共振扫描显示交通性脑积水,脑脊液检查显示 105 个白细胞/µL(≤5),主要为淋巴细胞,蛋白 1.35g/L(0.15-0.45),葡萄糖含量为 0.06mmol/L(3.3-4.4)。我们怀疑是感染性原因,并使用宏基因组下一代测序来诊断神经囊虫病。本病例突出了慢性脑膜炎的诊断挑战和遗传方法在诊断神经感染中的相关性。