致命的Mycobacterium avium脑膜炎在一个HIV阴性越南男子:一个病例报告
Van Thanh Nguyen1, Le Hong Van2, Guy Thwaites1,3
1Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, 700000, Vietnam.
Journal of medical case reports
|May 15, 2025
概括
通过Mycobacterium avium复合体感染中枢神经系统是罕见的,即使在免疫受损的个体. 这一案例突显了一个免疫能力不佳的男性的致命案例,强调了对非结核菌菌脑膜炎的快速诊断的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 神经学 神经学
- 微生物学 微生物学
背景情况:
- 非结核性真菌细菌 (NTM) 是环境真菌细菌,很少引起人类疾病,特别是在中枢神经系统 (CNS).
- 最常见的NTM - - Mycobacterium avium复合体 (MAC) 中枢神经系统感染异常罕见,即使在晚期的HIV感染中也是如此.
- 这份报告详细介绍了一例独特的MAC脑膜炎与脑出血病例,该病例发生在越南的一名未感染HIV的男性身上.
研究的目的:
- 报告一种罕见的Mycobacterium avium复合性脑膜炎与脑出血的病例.
- 要突出诊断挑战和临床表现中枢神经系统感染的NTM在一个免疫能力较强的个体.
- 强调及时诊断和适当治疗NTM中枢神经系统感染的重要性.
主要方法:
- 一个56岁的越南男性的案例研究,患有高血压,出现模仿细菌脑膜炎的症状.
- 诊断程序包括脑脊液 (CSF) 分析,酸速细菌涂抹,GeneXpert Ultra,线程探针测定和脑成像 (MRI,CT).
- 治疗涉及经验性抗生素,其次是NTM治疗方案,包括阿齐思罗米,利法和乙墨托.
主要成果:
- 脑脊液分析显示,白细胞数量高,中性友好细胞占主导地位,蛋白质含量高,葡萄糖含量低,与脑膜炎一致.
- 酸速细菌涂抹呈阳性;然而,分子测试 (GeneXpert Ultra) 呈阴性,而线式探针测定证实了Mycobacterium avium.
- 患者患有脑出血和心室内出血,最终因感染而死亡.
结论:
- 非结核性真菌菌菌中枢神经系统感染可能与不响应的发烧性细菌性脑膜炎类似.
- 快速准确的诊断对于有效管理这种可能致命的疾病至关重要.
- 这一案例强调了在脑膜炎的差异诊断中需要考虑NTM的必要性,无论艾滋病毒状况如何.
更多相关视频
10:04Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
18.7K
07:21Processing of Bronchoalveolar Lavage Fluid and Matched Blood for Alveolar Macrophage and CD4+ T-cell Immunophenotyping and HIV Reservoir Assessment
Published on: June 23, 2019
20.8K
相关概念视频
01:29Pulmonary Tuberculosis I
1.5K
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
1.5K
01:28Pulmonary Tuberculosis II
2.3K
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
2.3K
01:31Pulmonary Tuberculosis III
1.6K
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
1.6K
01:26Pulmonary Tuberculosis IV
746
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
746
01:28Pulmonary Tuberculosis V
922
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
922
01:18Viral Meningitis
146
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
146