一种与在海水中游泳相关的初级有菌性脑膜炎病例
Feng Wang1, Fuping Shen2, Wenchu Dai3
1Department of Laboratory Medicine, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo, China.
Parasitology research
|August 9, 2023
概括
一名渔民在海上游泳后死于由Naegleria fowleri引起的罕见脑部感染. 脑脊液 (CSF) 的高级测序识别了阿米巴,最初的测试错过了它.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 纳格莱里亚 (Naegleria fowleri) 是一种罕见但致命的阿米巴,会引起原发性阿米巴脑膜炎 (PAM).
- 早期诊断PAM是具有挑战性的,往往导致延迟或错过治疗.
- 患者病史和先进的分子技术对于识别罕见病原体至关重要.
研究的目的:
- 报告一个渔民感染Naegleria fowleri致命病例.
- 突出诊断挑战和宏基因组测序在识别PAM中的实用性.
- 强调在神经病例中考虑环境暴露的重要性.
主要方法:
- 一个62岁的男性渔民的神经症状的临床病例介绍.
- 审查初步诊断测试,包括CSF分析.
- 在CSF上应用宏基因组测序来识别病原体.
主要成果:
- 患者出现了严重的神经症状,包括吐,头痛和行为变化,进展到昏迷和死亡.
- 最初使用抗生素和皮质类固醇治疗是无效的.
- 在CSF的宏基因组测序最终确定了Naegleria fowleri感染.
- 标准实验室检测没有检测到感染.
结论:
- 在患有严重神经症状和有淡水或海水暴露史的患者中,应考虑感染Naegleria fowleri.
- 宏基因组测序是一个有价值的工具,用于诊断罕见的传染病原体,如Naegleria fowleri当传统方法失败时.
- 及时准确的诊断对于潜在的PAM治疗至关重要,尽管其死亡率很高.
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