隐秘表现:原发性有菌性脑膜炎,模仿高度恶性瘤,导致手术死亡48小时内. 一个说明性的案例
M Kodeeswaran1, Gaurav R Dhoka1, Jamila Alagarsamy2
1Departments of Neurosurgery, Government Kilpauk Medical College and Hospital, Kilpauk, Chennai, Tamil Nadu, India.
Journal of neurosurgery. Case lessons
|January 20, 2025
概括
初级虫脑膜炎 (PAM) 意外地在死后被诊断为患有占用空间的大脑病变的患者. 这个罕见的案例突显了PAM.
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:
- 一名71岁的男性出现了3个月的右上肢虚弱和头痛的病史.
- 大脑MRI揭示了占用左前部空间的病变,最初怀疑是高度恶性瘤.
- 患者在免疫光指导下进行了醒着的骨切除术,并切除了病变.
研究的目的:
- 报告一种极其罕见且前所未有的原发性虫脑膜炎 (PAM) 病例.
- 描述PAM模仿恶性脑瘤的诊断挑战和独特呈现.
主要方法:
- 分析了临床表现和神经成像发现.
- 进行了脑损伤的外科切除.
- 经手术后的过程和组织病理学分析被审查.
主要成果:
- 该病变显示了手术期间的光吸收,与外科指导一致.
- 手术后,患者患上脑膜炎,并因感染而死亡.
- 组织病理学证实了带有寄生虫感染的,确定了Naegleria fowleri作为PAM的致病原体.
结论:
- PAM可以非典型地呈现为占用空间的病变,模仿高度恶性瘤.
- 不特定的初始症状和误导性的成像发现导致诊断延迟.
- 这一案例强调了考虑罕见的传染病因的重要性,即使看似瘤呈现.
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