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急性淋巴细胞白血病范围内由蜡样芽孢杆菌引起的脑出血和多发性脑脓肿

[Intracerebral hemorrhage and multiple brain abscesses caused by Bacillus cereus within the scope of acute lymphatic leukemia].

作者信息

Strittmatter M, Hamann G, Sahin U, Feiden W, Kohl K, Schimrigk K

机构信息

Neurologische Universitätsklinik, Universität des Saarlandes, Homburg.

出版信息

Nervenarzt. 1995 Oct;66(10):785-8.

PMID:7501096
Abstract

Multiple hematogenic brain abscesses in immunosuppression are occasionally caused by rare and primary apathogenic causative agents. We report a first case of an isolated CNS infection by Bacillus cereus, which led to death from multiple brain abscesses and an intracerebral hemorrhage, probably caused by the infection, within 4 days. The underlying disease leading to immunosuppression was acute lymphatic leukemia in complete remission. In spite of antibiotic therapy the chemotherapy-induced neutropenia enabled unhindered spreading of the necrotizing infection, which was verified by histological analysis. The production of potent toxins such as hemolysin and cerelolysin by B. cereus leads to rapid and fulminant tissue destruction usually involving the walls of blood vessels.

摘要

免疫抑制状态下的多发性血源性脑脓肿偶尔由罕见的原发性无致病性病原体引起。我们报告了首例由蜡样芽孢杆菌引起的孤立性中枢神经系统感染病例,该病例在4天内死于多发性脑脓肿和可能由感染导致的脑出血。导致免疫抑制的基础疾病是完全缓解期的急性淋巴细胞白血病。尽管进行了抗生素治疗,但化疗引起的中性粒细胞减少使得坏死性感染得以不受阻碍地扩散,这一点通过组织学分析得到证实。蜡样芽孢杆菌产生的溶血素和 cereolysin 等强效毒素会导致快速且暴发性的组织破坏,通常累及血管壁。

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