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成人空肠弯曲菌胎儿脑膜炎

[Campylobacter fetus meningitis in adults].

作者信息

Wilhelm J M, Saraceni O, Penner M F, Trévoux A, Kieffer P

机构信息

Service de Médecine, Centre hospitalier Saint-Morand, Altkirch.

出版信息

Presse Med. 1996 Oct 5;25(29):1331-2.

PMID:8942943
Abstract

Campylobacter fetus is an uncommon cause of meningitis in the adult. We report a case observed in an 84-year-old man with alcoholic cirrhosis. The patient presented fever, jaundice and a state of mental confusion. Blood and cerebrospinal fluid cultures identified Campylobacter fetus sensitive to several antibiotics. Ciprofloxacine-ceftriaxone combination replaced the antibiotics prescribed empirically prior to identification and led to regression of the fever and normal mental status within 4 days. Spinal tap on day 7 showed 20 white cells, 85% lymphocytes and normal protein level. Unfortunately, the patient later developed edema and ascitis with major jaundice. Oligo-anuria could not be controlled and the patient died two weeks after admission. Campylobacter fetus meningitis is predominantly seen in men, mean age of onset 50 years. Clinical signs are not specific and diagnosis can only be obtained on the basis of cerebrospinal fluid results. Adapted antibiotics are required.

摘要

胎儿弯曲杆菌是成人脑膜炎的罕见病因。我们报告一例在一名84岁酒精性肝硬化男性患者中观察到的病例。该患者出现发热、黄疸和精神错乱状态。血液和脑脊液培养鉴定出对多种抗生素敏感的胎儿弯曲杆菌。环丙沙星-头孢曲松联合用药取代了鉴定前经验性使用的抗生素,并在4天内使发热消退且精神状态恢复正常。第7天的腰椎穿刺显示有20个白细胞,85%为淋巴细胞,蛋白水平正常。不幸的是,患者后来出现水肿和腹水,并伴有严重黄疸。少尿-无尿无法得到控制,患者在入院两周后死亡。胎儿弯曲杆菌脑膜炎主要见于男性,平均发病年龄为50岁。临床症状不具特异性,只能根据脑脊液结果做出诊断。需要使用合适的抗生素。

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