免疫功能正常宿主的脑膜孢子丝菌病：一例报告

Meningeal sporotrichosis in an immunocompetent host: A case report.

作者信息

Ribeiro Victor Teatini, Caligiorne Rachel Basques, Martins Aldrin Pedroza, Gomes Neto Antônio Pereira, Christo Paulo Pereira

机构信息

Departament of Neurology, Santa Casa de Belo Horizonte Hospital, Belo Horizonte (MG), Brazil.

Faculdade Santa Casa BH, Programa de Pós-graduação Stricto Sensu, Belo Horizonte (MG), Brazil.

出版信息

Med Mycol Case Rep. 2024 Aug 28;45:100665. doi: 10.1016/j.mmcr.2024.100665. eCollection 2024 Sep.

DOI:10.1016/j.mmcr.2024.100665

PMID:39290785

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11406475/

Abstract

A 78-year-old woman presented to hospital with altered mental status. Hyponatremia was diagnosed and treated. She maintained mental confusion despite normal sodium. No headache, fever or focal signs were present. CSF analysis showed chronic meningitis; MRI demonstrated basilar enhancement. She was empirically treated for tuberculosis, with no improvement. PCR for in the CSF was positive. After treatment with Amphotericin followed by oral itraconazole, she completely recovered her cognitive abilities. Follow-up CSF was normal. This report illustrates the need to consider sporotrichosis in the differential diagnosis of chronic meningitis in immunocompetent, and the importance of PCR as a diagnostic tool.

摘要

一名78岁女性因精神状态改变入院。诊断为低钠血症并进行了治疗。尽管血钠正常，但她仍存在精神错乱。无头痛、发热或局灶性体征。脑脊液分析显示为慢性脑膜炎；磁共振成像（MRI）显示基底节强化。她接受了抗结核经验性治疗，但无改善。脑脊液的曲霉菌聚合酶链反应（PCR）检测呈阳性。在用两性霉素治疗后口服伊曲康唑，她的认知能力完全恢复。随访脑脊液正常。本报告说明了在免疫功能正常者慢性脑膜炎的鉴别诊断中需要考虑孢子丝菌病，以及PCR作为诊断工具的重要性。