多焦点内密码菌与治疗耐药性,复发和死亡率:一个病例报告和文献综述
Masashi Higashino1,2, Eiji Kurihara1, Ryuichi Kuroda1
1Department of Neurosurgery, Junshin Hospital, Kakogawa, Hyogo, Japan.
NMC case report journal
|December 17, 2025
概括
内加密瘤是一种罕见的脑部感染,呈现为环增强性病变. 这一案例凸显了警的随访的重要性和复发的可能性,即使在延长了对中枢神经系统密码球菌的抗真菌治疗后.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 放射学 放射学是指放射学
背景情况:
- 内加密瘤是一种罕见的中枢神经系统加密瘤,由于环增强性病变,在成像上经常模仿恶性脑瘤.
- 早期诊断和长期的抗真菌治疗对于管理这种疾病和改善患者的治疗结果至关重要.
- 标准治疗包括密集的诱导疗法,然后是长时间的维持疗法.
研究的目的:
- 描述一个免疫能力强的患者内密码瘤病例的临床进展.
- 强调实现完全缓解的挑战和复发风险.
- 强调活检的重要性和当治疗不够优时的仔细监测.
主要方法:
- 一个66岁的免疫能力强的男性病例报告显示,他患有多种脑损伤和肺损伤.
- 通过切除大脑病变,通过组织病理学证实了加密瘤.
- 治疗涉及延长的诱导疗法与脂质体安福特 B 和流动,随后是弗卢科纳维护,随后的复发和重新治疗.
主要成果:
- 患者接受了八周的诱导疗法,超过标准持续时间,但只实现了损伤的部分回归.
- 维持治疗开始后五个月观察到复发,需要重新诱导和进一步调整治疗.
- 尽管进行了积极的治疗,但患者的病情恶化,在开始抗真菌治疗15个月后死亡.
结论:
- 内加密瘤带来了重大的诊断和治疗挑战,即使在免疫能力良好的人身上也是如此.
- 当成像对恶性瘤不典型时,活检对于准确的诊断和治疗计划至关重要.
- 由于初始治疗后复发的重大风险,密切的临床和放射学随访至关重要.
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