没有由Coccidioides immitis引起的脑膜炎的孤独的乳头:一个说明性的案例
Adhith Palla1, Nora C Kim1, Sarra Belakhoua2
1Department of Neurosurgery, NYU Grossman School of Medicine, New York, New York.
Journal of neurosurgery. Case lessons
|October 27, 2025
概括
一种由Coccidioides immitis引起的罕见的乳头已经成功地用手术,德克萨米他和长期的弗卢科纳治疗,即使最初的真菌检测结果是负面的. 这一案例突出了深层次的真菌脑的有效管理.
科学领域:
- 菌类学 菌类学是指菌类学.
- 神经学 神经学
- 传染性疾病 传染性疾病
背景情况:
- 脑的预后取决于位置和生物体,深部会带来高死亡风险.
- 由Coccidioides immitis引起的Coccidioidomycosis正在增加,但很少形成深层脑,导致管理策略不清楚.
- 这份报告详细介绍了一例独特的单独的脑膜瘤Coccidioides,没有脑膜炎.
研究的目的:
- 报告诊断和治疗Coccidioides immitis.is引起的罕见单独的乳头.
- 突出诊断挑战,包括负真菌培养和血清学.
- 概述一种有效的治疗策略,用于深层次的真菌脑.
主要方法:
- 一名59岁的女性出现了神经缺陷,暗示大脑损伤.
- 进行了立体脑活检,尽管存在负的真菌培养物和血清抗体,但却发现了Coccidioides球状体.
- 通过对活检组织进行聚合酶链反应 (PCR) 测试来确认诊断.
主要成果:
- 患者的症状在手术和甲治疗后3周内消失.
- 终身弗卢科纳治疗被规定以防止复发.
- 随访1年后,患者仍然没有患病,尽管在11个月后停止服用弗卢可纳.
结论:
- Coccidioides immitis可以表现为单独的脑,即使是负真菌培养.
- 结合德克萨米他和长时间的弗卢科纳治疗的手术干预有效地清除感染并防止复发.
- 这个案例为管理不常见的深层真菌脑提供了宝贵的见解.
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