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使用FilmArray脑膜炎/脑炎检测板诊断先前有抗生素暴露史患者的单核细胞增生李斯特菌脑膜炎:一例报告

Diagnosis of Listeria monocytogenes Meningitis Using the FilmArray Meningitis/Encephalitis Panel in a Patient With Prior Antibiotic Exposure: A Case Report.

作者信息

Miyazaki Yu, Tominaga Koki, Adachi Takuya

机构信息

Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital, Tokyo, JPN.

Department of Infectious Diseases, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, JPN.

出版信息

Cureus. 2025 Jul 10;17(7):e87687. doi: 10.7759/cureus.87687. eCollection 2025 Jul.

Abstract

Bacterial meningitis is a medical emergency with high mortality rates and a significant risk of complications. Conventional diagnostic methods, such as Gram staining, sometimes fail to identify the causative pathogen, and cultures take time to yield results. The FilmArray meningitis/encephalitis (ME) Panel, a molecular diagnostic tool, identifies 14 pathogens in approximately one hour. We report a case of meningitis in a 79-year-old man, diagnosed using the FilmArray ME Panel after antibiotic exposure. The diagnosis was made on day seven, three days after admission, using a cerebrospinal fluid sample that had been stored due to the unavailability of the test over the weekend. Despite negative cultures, the panel facilitated diagnosis and effective treatment with ampicillin and gentamicin, leading to full recovery without sequelae. This case highlights the utility of the FilmArray ME Panel in challenging diagnostic scenarios and underscores the importance of ensuring its availability during after-hours and weekends to facilitate timely care in critical conditions.

摘要

细菌性脑膜炎是一种具有高死亡率和显著并发症风险的医疗急症。传统诊断方法,如革兰氏染色,有时无法识别致病病原体,培养则需要时间才能得出结果。FilmArray脑膜炎/脑炎(ME)检测板是一种分子诊断工具,可在约一小时内识别14种病原体。我们报告一例79岁男性脑膜炎病例,该病例在抗生素暴露后使用FilmArray ME检测板进行诊断。诊断于入院三天后的第七天做出,使用的是因周末无法进行检测而保存的脑脊液样本。尽管培养结果为阴性,但该检测板有助于诊断并采用氨苄西林和庆大霉素进行有效治疗,患者完全康复且无后遗症。该病例突出了FilmArray ME检测板在具有挑战性的诊断场景中的实用性,并强调了确保其在非工作时间和周末可用以促进危急情况下及时治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7bb/12335352/2e94a23344e9/cureus-0017-00000087687-i01.jpg

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