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两例由……引起的脑膜脑炎报告

A Report of Two Cases of Meningoencephalitis Caused by .

作者信息

Pan Jun-Li, Wu Wen-Jun, Zeng Shu-Yan, Xu Jia-He, Lu Kui

机构信息

Department of Neurology, Zhongshan City People's Hospital, Zhongshan, Guangdong province, 528403, People's Republic of China.

Department of MRI Room, Zhongshan City People's Hospital, Zhongshan, Guangdong province, 528403, People's Republic of China.

出版信息

Infect Drug Resist. 2024 May 31;17:2189-2198. doi: 10.2147/IDR.S438615. eCollection 2024.

Abstract

OBJECTIVE

In this paper, we analyzed the clinical data of patients with meningoencephalitis caused by to understand better the clinical characteristics of the disease and recommend auxiliary diagnostic mode as well as treatment experience.

METHODS

We reviewed the clinical data of two patients admitted to our department in 2019 with meningoencephalitis caused by .

RESULTS

Two female patients were examined, one of whom had a history of radiotherapy for nasopharyngeal carcinoma while the other had no underlying disease. These two patients were admitted with symptoms of meningoencephalitis. Cerebrospinal fluid examinations revealed elevated levels of leukocytes and protein. After treatment with meropenem, the condition improved for a brief time, but then worsened with a decline in mental status and limb movement. Blood and cerebrospinal fluid cultures demonstrated the absence of pathogenic bacteria, while genome sequencing of cerebrospinal fluids revealed the presence of . Cranial magnetic resonance imaging revealed multiple cerebral abscesses (CAs). After coadministration of linezolid as an anti-infective, clinical symptoms gradually improved, and the CAs shrank on follow-up imaging. The condition exhibited a pattern of improvement-deterioration-improvement.

CONCLUSION

Meningoencephalitis caused by is complex and prone to fluctuation and formation of multiple CAs. The definitive clinical diagnosis of this disease can be aided by genome sequencing technology, and early clarification of the etiology combined with the use of potent antibiotics is effective.

摘要

目的

本文通过分析由[病原体名称未给出]引起的脑膜脑炎患者的临床资料,以更好地了解该疾病的临床特征,并推荐辅助诊断模式及治疗经验。

方法

我们回顾了2019年收治于我科的2例由[病原体名称未给出]引起的脑膜脑炎患者的临床资料。

结果

检查了2例女性患者,其中1例有鼻咽癌放疗史,另1例无基础疾病。这2例患者均因脑膜脑炎症状入院。脑脊液检查显示白细胞和蛋白质水平升高。美罗培南治疗后病情短暂改善,但随后恶化,精神状态和肢体活动下降。血培养和脑脊液培养均未发现病原菌,而脑脊液基因组测序显示存在[病原体名称未给出]。头颅磁共振成像显示多发性脑脓肿(CAs)。联合使用利奈唑胺抗感染后,临床症状逐渐改善,随访影像学显示CAs缩小。病情呈现改善-恶化-改善的模式。

结论

由[病原体名称未给出]引起的脑膜脑炎病情复杂,易波动且易形成多发性CAs。基因组测序技术有助于该疾病的明确临床诊断,早期明确病因并联合使用强效抗生素有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90fb/11149631/0dcee9b75bcb/IDR-17-2189-g0001.jpg

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