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[一名患者真菌播散期间的脑炎(临床及尸检结果)(作者译)]

[Encephalitis during mycotic dissemination in a patient (clinical and post mortem findings) (author's transl)].

作者信息

Pizzolato G P, Di Trapani G, Polonnelli L

出版信息

Riv Patol Nerv Ment. 1977 Feb;97(1):7-17.

PMID:854681
Abstract

A case of disseminated mycosis with encephalitis unobserved in life is reported. A mycosis infection ought always be taken into consideration every time that a clinical impression of encephalitis, meningitis or cerebral abcess is reached. Criptococcosis, Histoplasmosis and Candidiasis may present as a meningitis, which the Nocardiasis and the Cladosporosis may appear as an intracranial abscess in the absence of significant lesions of other organs. Many deep mycosis prove to have characteristic lesions in other organs before affecting the Central Nervous System. Development therefore of neurological symptoms ought to make one think of a dissemination at CNS level. Finally Candidosis and Aspergillosis ought to be suspected in all cases of progressive general weakeness after an illness especially when treated with antibiotics, citotoxis drugs, or hormonal steroids. In many cases the neurological lesions represant a manifestation of terminal type in a subject with many more lesions than one would suspect at first.

摘要

报告了一例生前未被发现的播散性真菌病合并脑炎病例。每当得出脑炎、脑膜炎或脑脓肿的临床印象时,都应始终考虑真菌病感染。隐球菌病、组织胞浆菌病和念珠菌病可能表现为脑膜炎,而诺卡菌病和枝孢菌病在其他器官无明显病变时可能表现为颅内脓肿。许多深部真菌病在影响中枢神经系统之前,在其他器官会出现特征性病变。因此,神经系统症状的出现应使人想到中枢神经系统层面的播散。最后,在疾病后出现进行性全身虚弱的所有病例中,尤其是在用抗生素、细胞毒性药物或激素类固醇治疗时,应怀疑念珠菌病和曲霉病。在许多情况下,神经病变是一个患者终末期的表现,其病变比最初怀疑的要多得多。

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