一个七十多岁的女人发烧和抽
Eli Leirdal Hoem1, Torleiv Kvalvik1, Ruben Dyrhovden2
1Infeksjonsmedisinsk seksjon, Haukeland universitetssjukehus.
概括
查加斯脑炎是慢性查加斯病重新激活的罕见并发症,发生在免疫抑制的心脏移植患者身上. 通过脊髓液显微镜及时诊断和联合抗寄生虫治疗导致神经系统完全恢复.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
背景情况:
- 查加斯病是由Trypanosoma cruzi引起的,在拉丁美洲移民中很普遍.
- 慢性查加斯病的重新激活可能发生在免疫抑制的个体中,特别是在移植后.
- 虽然心肌炎是一种已知的并发症,但查加斯脑炎是一种罕见但严重的表现.
研究的目的:
- 在免疫抑制心脏移植接受者中报告查加斯脑炎病例.
- 要突出脑脊液显微镜对Trypanosoma cruzi的诊断效用.
- 强调通过及时的抗寄生虫治疗,完全康复的潜力.
主要方法:
- 一个七十多岁的心脏移植患者的病例介绍,患有查加斯病.
- 诊断方法包括脊髓液显微镜 (湿和吉姆萨染料) 和脑CT.
- 在世界卫生组织 (WHO) 的支持下,治疗包括尼达和尼福蒂莫克斯.
主要成果:
- 患者表现出神经症状,包括,头痛和视觉障碍.
- 脊髓液分析证实了Trypanosoma cruzi trypomastigotes的存在,诊断出脑膜炎.
- 尽管最初情况恶化,但患者在60天的治疗后实现了完全的认知和神经恢复.
结论:
- 查加斯脑炎虽然很少见,但必须考虑在患有慢性查加斯病的神经症状的免疫抑制患者.
- 脑脊液的显微镜检查对于快速诊断至关重要.
- 积极的抗寄生虫疗法即使在严重的病例中也可以带来良好的结果.
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