Sarah McCarthy is Adjunct Clinical Faculty, University of Minnesota School of Nursing, Adult and Gerontological Health Cooperative, School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455 (
Nicholas Villarreal is Nurse Practitioner, University of Minnesota Physicians, Department of Cardiology, Minneapolis, Minnesota.
AACN Adv Crit Care. 2024 Sep 15;35(3):244-250. doi: 10.4037/aacnacc2024820.
A 69-year-old woman without significant medical history presented to an emergency department for evaluation and management of altered mental status and a 10-day history of worsening symptoms of upper respiratory infection. Two days previously, she had been evaluated at an urgent care center, where she reported productive cough and neck pain. Evaluation in the emergency department aroused suspicions of sepsis and meningitis, and computed tomography of the head revealed nontraumatic pneumocephalus with evidence of bony erosion of the sinus into the brain. Culture results revealed disseminated Streptococcus pneumoniae. Cerebral vasculopathy secondary to the meningitis caused bilateral acute ischemic strokes in areas of the brain, with the potential to lead to significant disability.
一位 69 岁的老年女性，既往无重大病史，因精神状态改变和上呼吸道感染症状恶化 10 天到急诊就诊，以进行评估和治疗。两天前，她在一家急诊中心就诊，自述有咳痰和颈部疼痛。在急诊的评估中，怀疑有败血症和脑膜炎，头部 CT 显示非创伤性的气颅，伴有窦向脑内侵蚀的骨侵蚀证据。培养结果显示肺炎链球菌广泛传播。脑膜炎引起的脑血管病导致大脑双侧急性缺血性中风，可能导致严重残疾。
