一例肺结核并发隐球菌、链球菌和结核性脑膜炎的罕见病例报告。
A rare case report of concurrent cryptococcal, streptococcal, and tuberculous meningitis in a patient with pulmonary tuberculosis.
机构信息
Department of Clinical Laboratory, The Fourth People's Hospital of Nanning, Nanning, China.
Key Laboratory of Infectious Diseases, The Fourth People's Hospital of Nanning, Nanning, China.
出版信息
Medicine (Baltimore). 2024 Oct 25;103(43):e40276. doi: 10.1097/MD.0000000000040276.
RATIONALE
Meningitis caused by concurrent infections with Cryptococcus neoformans, Streptococcus equi subsp. equi, and Mycobacterium tuberculosis is extremely rare.
PATIENT CONCERNS
We present the case of a 63-year-old male patient who presented with headaches, dizziness, nausea, vomiting, and fever for the past 3 weeks.
DIAGNOSES
The patient was diagnosed with concurrent cryptococcal, streptococcal, and tuberculous meningitis.
INTERVENTIONS
The patient received isoniazid, rifampicin, ethambutol, and levofloxacin for 1 month, in addition to liposomal amphotericin B with flucytosine for 2 weeks, followed by fluconazole with flucytosine for additional 2 weeks.
OUTCOMES
The symptoms improved, and outpatient therapy was continued.
LESSONS
Infectious meningitis requires a combination of microscopy, culture, and rapid molecular diagnostics for early diagnosis and treatment.
理由
由新型隐球菌、马链球菌马亚种和结核分枝杆菌并发感染引起的脑膜炎极为罕见。
病例介绍
我们报告了一例 63 岁男性患者，该患者因头痛、头晕、恶心、呕吐和发热持续了 3 周。
诊断
该患者被诊断为新型隐球菌、马链球菌马亚种和结核分枝杆菌并发脑膜炎。
干预措施
该患者接受了异烟肼、利福平、乙胺丁醇和左氧氟沙星治疗 1 个月，此外还接受了两性霉素 B 脂质体联合氟胞嘧啶治疗 2 周，然后继续氟康唑联合氟胞嘧啶治疗 2 周。
结果
症状改善，继续门诊治疗。
教训
感染性脑膜炎需要结合显微镜检查、培养和快速分子诊断，以便早期诊断和治疗。
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