临床推理：一名患有头痛和嗜酸性粒细胞增多症的26岁女性。

Clinical Reasoning: A 26-Year-Old Woman With Headache and Eosinophilia.

作者信息

Goh Wilson Guo Wei, Ng Isaac Kah Siang, Tan Marcus Kai Xuan, Fong Clare Yoke Kum, Chua Christopher Yuan Kit, Yan Gabriel Zherong, Chavatte Jean-Marc, Soon Derek Tuck Loong, Hui Andrew Che-Fai, Tambyah Paul Ananth, Myint May Zin

机构信息

Division of Infectious Diseases, Department of Medicine, National University Hospital of Singapore.

Department of Medicine, National University Hospital of Singapore.

出版信息

Neurology. 2025 Mar 25;104(6):e213434. doi: 10.1212/WNL.0000000000213434. Epub 2025 Feb 21.

DOI:10.1212/WNL.0000000000213434

PMID:39983059

Abstract

Headache accompanied by eosinophilia in blood or CSF presents a complex clinical challenge. We present a case of a 26-year-old woman with headache, peripheral eosinophilia with meningeal enhancement, and intracranial vasculopathy on imaging. This case illustrates a systematic approach to a patient with meningitis, peripheral eosinophilia, and cerebral vasculitis, which includes comprehensive clinical history taking and appropriate investigative workup to differentiate between infectious and noninfectious causes and timely tissue sampling to conclusively determine the causative agent.

摘要

伴有血液或脑脊液嗜酸性粒细胞增多的头痛带来了复杂的临床挑战。我们报告一例26岁女性病例，该患者有头痛、外周血嗜酸性粒细胞增多伴脑膜强化，影像学检查显示颅内血管病变。本病例说明了针对患有脑膜炎、外周血嗜酸性粒细胞增多和脑血管炎患者的系统诊疗方法，包括全面采集临床病史、进行适当的检查以区分感染性和非感染性病因，以及及时进行组织采样以最终确定病原体。