巴拉穆提亚·曼德里拉里斯 (Balamuthia mandrillaris) 是一种模仿结核性脑膜炎的有菌脑炎
Yoya Ono1, Kazuhiro Higashida1, Kanako Yamanouchi2
1Department of Neurology, Gifu University Graduate School of Medicine, Gifu, Japan.
概括
巴拉穆提亚曼德里拉里斯 (Balamuthia mandrillaris) 导致致命的有菌性脑膜炎,模仿结核性脑膜炎. 诊断需要大脑活检,因为非特异性症状和具有挑战性的微生物测试.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 病理学 病理学 病理学
背景情况:
- 麻疹性脑膜炎 (AME) 是一种罕见的,往往致命的中枢神经系统感染.
- 艾美可能会出现模仿其他神经疾病的症状,例如结核性脑膜炎 (TBM).
- 由于非特异性临床表现和微生物识别方面的困难,对AME的准确和及时诊断具有挑战性.
研究的目的:
- 报告一个由Balamuthia mandrillaris引起的致命AMEE病例.
- 突出 AME 与 TBM 区分的诊断挑战.
- 强调在没有对治疗反应的TBM类症状的情况下考虑AME的重要性.
主要方法:
- 一个76岁的女性病例介绍,她的神经病情逐渐恶化.
- 脑脊液分析,脑部MRI,以及对疑似TBM的经验性治疗.
- 脑内镜活检用于组织病理学检查和致病剂的分子鉴定.
主要成果:
- 脑部活检显示了通过16S核糖体RNA测序识别的带有Balamuthia mandrillaris的氨基脑炎.
- 患者的病情恶化,尽管最初的抗生素,抗病毒和抗结核病疗法.
- 尸体解剖证实大脑组织中存在广泛的氨基囊.
结论:
- 巴拉穆提亚曼德里拉里斯 (Balamuthia mandrillaris) 可以引起AME,其临床和放射性特征与TBM无法区分.
- 对TBM的微生物测试可能是负面的或不确定的,使诊断复杂化.
- 侵袭性脑活检对于确定AME诊断至关重要,特别是当怀疑但未证实TBM时.
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