免疫功能正常宿主的都柏林念珠菌脑膜炎:病例报告和文献综述。

IF 2.3 Q3 CLINICAL NEUROLOGY
Neurology. Clinical practice Pub Date : 2024-08-01 Epub Date: 2024-05-16 DOI:10.1212/CPJ.0000000000200279
Asra Askari, Jemma Benson, Lucas Felipe Bastos Horta, Ali Daneshmand, Hormuzdiyar Dasenbrock, Anna M Cervantes-Arslanian
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引用次数: 0

摘要

目的:本研究介绍了一例免疫功能正常的注射吸毒者的杜布林念珠菌脑膜炎病例,并对与杜布林念珠菌相关的中枢神经系统感染进行了文献综述:本研究介绍了一例免疫功能正常的注射吸毒者患上杜布林念珠菌脑膜炎的病例,并对与杜布林念珠菌相关的中枢神经系统感染进行了文献综述:一名有阿片类药物使用障碍病史的 32 岁男子因癫痫发作接受了广泛的诊断评估,包括影像学检查、腰椎穿刺和组织活检。治疗包括抗真菌治疗和脑室腹腔分流术(VPS):结果:从后窝蛛网膜样本中培养出杜布林杆菌脑膜炎。患者的影像学表现为脑膜增厚,服用氟康唑 20 周后症状缓解。由于出现脑积水,患者需要接受 VPS 治疗。其他已发表的杜布林杆菌脑膜炎病例显示了不同的表现、诊断方法和治疗方案:讨论:杜布林杆菌脑膜炎是一种罕见的疾病,免疫力低下和免疫力正常的人都会感染,尤其是静脉注射毒品的人。诊断具有挑战性,通常需要重复腰椎穿刺、大量脑脊液取样或脑膜活检。治疗需要联合使用抗真菌药物,如两性霉素 B 和氟康唑。颅内高压和脑积水可能需要手术治疗。总之,杜布林杆菌脑膜炎应被视为脑膜炎的潜在病因,尤其是那些有注射吸毒史的人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Candida Dublinensis Meningitis in an Immunocompetent Host: A Case Report and Review of the Literature.

Objectives: This study presents a case of Candida dubliniensis meningitis in an immunocompetent injection drug user and provides a literature review of CNS infections related to C dubliniensis.

Methods: A 32-year-old man with a history of opioid use disorder presented with seizures and underwent extensive diagnostic evaluations, including imaging, lumbar puncture, and tissue biopsies. Treatment consisted of antifungal therapy and placement of ventriculoperitoneal shunt (VPS).

Results: C dublinensis meningitis was identified on culture from a posterior fossa arachnoid sample. The patient demonstrated leptomeningeal enhancement on imaging, which resolved following 20 weeks of fluconazole. The development of hydrocephalus necessitated placement of VPS. Additional published cases of C dublinensis meningitis revealed varying presentations, diagnostic methods, and treatment regimens.

Discussion: C dublinensis meningitis is a rare condition affecting both immunocompromised and immunocompetent individuals, particularly those with intravenous drug use. The diagnosis can be challenging, often requiring repeat lumbar punctures, extensive CSF sampling, or meningeal biopsy. Treatment involves a combination of antifungal agents, such as amphotericin B and fluconazole. Intracranial hypertension and hydrocephalus may necessitate surgical intervention. In conclusion, C dublinensis meningitis should be considered as a potential etiology of meningitis, particularly in those with a history of injection drug use.

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来源期刊
Neurology. Clinical practice
Neurology. Clinical practice CLINICAL NEUROLOGY-
CiteScore
4.00
自引率
0.00%
发文量
77
期刊介绍: Neurology® Genetics is an online open access journal publishing peer-reviewed reports in the field of neurogenetics. The journal publishes original articles in all areas of neurogenetics including rare and common genetic variations, genotype-phenotype correlations, outlier phenotypes as a result of mutations in known disease genes, and genetic variations with a putative link to diseases. Articles include studies reporting on genetic disease risk, pharmacogenomics, and results of gene-based clinical trials (viral, ASO, etc.). Genetically engineered model systems are not a primary focus of Neurology® Genetics, but studies using model systems for treatment trials, including well-powered studies reporting negative results, are welcome.
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