中枢神经系统密码球菌与大脑干出血在化疗期间为儿科急性髓母细胞白血病患者
Sawa Tomomatsu1, Kozo Nagai1, Kanji Tsuruta2
1Department of Pediatrics, Ehime Prefectural Central Hospital, Matsuyama, Japan.
概括
加密球菌脑膜炎在接受化疗的急性髓性白血病患者中很少见. 脑脊液的多重遗传检测有助于在这种非典型的病例中进行诊断,这种病例呈现出类似中风的症状.
科学领域:
- 菌类学 菌类学是指菌类学.
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 密码球菌是一种真菌感染,在化疗期间在癌症患者中很少见.
- 接受密集化疗的急性髓性白血病 (AML) 患者容易感染机会性感染.
研究的目的:
- 在小儿AML患者中报告一种非典型的加密球菌脑膜炎病例.
- 突出诊断挑战和多重基因测试在免疫功能低下患者的实用性.
主要方法:
- 一个患有AML的10岁女孩接受了密集化疗.
- 进行了脑脊液 (CSF) 分析和Biofire® FilmArray®脑膜炎/脑炎 (ME) 面板.
- 治疗包括抗真菌疗法和免疫复合炎症综合征 (IRIS) 的管理.
主要成果:
- 患者在化疗期间出现了类似中风的症状 (半,神经麻).
- 对于常见的病原体,CSF分析最初是不确定的,但ME小组检测到了*Cryptococcus neoformans*.
- 对IRIS的抗真菌治疗和类固醇导致神经系统逐渐恢复.
结论:
- 加密球菌脑膜炎可以在中性衰竭AML患者中呈现异常,具有类似中风的症状.
- 多重遗传测试对于诊断免疫功能低下个体中中枢神经系统感染有价值,当传统的CSF测试呈阴性结果时.
- 早期诊断和治疗对于控制中枢神经系统的真菌感染和相关并发症,如IRIS至关重要.
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