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重症监护病房中新发难治性癫痫持续状态及非结核分枝杆菌中枢神经系统感染的多学科方法与分子诊断:一例报告

Multidisciplinary Approaches and Molecular Diagnostics in New-Onset Refractory Status Epilepticus and Nontuberculous Mycobacterial CNS Infections in the ICU: A Case Report.

作者信息

Batarda Sena Pedro Manuel, Ferro Margarida, Alves Cabrita Joana, Pontinha Carlos, Mestre Ana, Oliveira Mário, Bento Luis

机构信息

Intensive Care Department, Hospital Central do Funchal, Funchal, PRT.

Neurology Department, Hospital de S. José, Unidade Local de Saúde de São José, Lisbon, PRT.

出版信息

Cureus. 2024 Dec 26;16(12):e76449. doi: 10.7759/cureus.76449. eCollection 2024 Dec.

Abstract

The diagnosis and management of complex neurological conditions such as New-Onset Refractory Status Epilepticus (NORSE) and central nervous system (CNS) infections caused by non-tuberculous mycobacteria (NTM) pose substantial difficulties in intensive care units (ICUs). This article combines a case report and a literature review that explores the diagnostic dilemmas and therapeutic strategies for these critical conditions. We report the case of an 83-year-old female with chronic granulomatous meningitis secondary to NTM, presenting a challenging diagnostic and complex management complexity typical of such a rare disease through a period time of five years. Her case emphasized the importance of a multidisciplinary approach in such cases, as the interplay between neurology and intensive care was vital. The need for new molecular diagnostic technologies is shown to be of high significance in identifying the causative pathogens and improving patient outcomes in these rare but critical conditions.

摘要

在重症监护病房(ICU)中,对诸如新发难治性癫痫持续状态(NORSE)和非结核分枝杆菌(NTM)引起的中枢神经系统(CNS)感染等复杂神经系统疾病的诊断和管理存在重大困难。本文结合了一例病例报告和文献综述,探讨了这些危急病症的诊断困境和治疗策略。我们报告了一例83岁女性患者,她患有由NTM引起的慢性肉芽肿性脑膜炎,在五年的时间里呈现出这种罕见疾病典型的具有挑战性的诊断和复杂的管理复杂性。她的病例强调了多学科方法在此类病例中的重要性,因为神经科与重症监护之间的相互作用至关重要。新的分子诊断技术对于识别致病病原体以及改善这些罕见但危急病症的患者预后具有高度重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2cd/11763716/af1ae44570fb/cureus-0016-00000076449-i01.jpg

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