结核性脑膜炎

注册

 

发新话题 回复该主题

NEJM新型隐球菌脑膜脑炎 [复制链接]

1#
SEM百度竞价招聘求职微信群 https://www.edunews.net.cn/2021/ywbb_0915/133267.html

A36-year-oldmanpresentedtotheemergencydepartmentwitha2-weekhistoryoffever,headache,drowsiness,andphotophobia.

36岁,男性,发热、头痛、嗜睡和畏光2周就医。

Hewaspreviouslyhealthyandwassexuallyactivewithmen.

既往体健,是同性恋。

Thephysicalexaminationwasnotableforatemperatureof38.3°Candneckstiffness.

体魄查看:体温38.3℃和颈部坚硬。

Computedtomographyoftheheadwasnormal.

脑袋CT一般。

Theopeningpressureonlumbarpuncturewas29cmofwater(referencerange,20cm).

腰椎穿刺的颅内压力为29cm水柱(参考界限,20cm)。

Thecerebrospinalfluid(CSF)cellcountwascellspermicroliter(referencerange,0to10),with90%mononuclearcells,whichwerepredominantlylymphocytes.

脑脊液(CSF)细胞计数为每微升个细胞(参考界限,0至10),此中90%的单核细胞,主若是淋巴细胞。

Theglucoselevelwas46mgperdeciliter(2.6mmolperliter;referencerange,40to70mgperdeciliter[2.2to3.8mmolperliter]),andtheproteinlevelwas0.80gperliter(referencerange,0.15to0.45).

葡萄糖程度为每分升46毫克(每升2.6毫摩尔;参考界限,每分升40-70毫克[2.2-3.8毫摩尔/升]),卵白质程度为每升0.80克(参考界限,0.15-0.45)。

Gram’sstain(PanelA)andIndiainkstain(PanelB)revealedabundantencapsulated,roundyeasts,withsomebuddingforms.

革兰氏染色(PanelA)和印度墨水染色(PanelB)显示出大批有(胶)囊包着的圆形酵母,以及一些出芽形势。

Thecryptococcalantigentiterwas1:,andtheCSFculturegrewCryptococcusneoformans.

隐球菌抗原效价为1:,脑脊液培植新式隐球菌。

Nootherpathogenwasdetected.

未发掘其余病原体。

Atestforthehumanimmunodeficiencyvirusantibodywaspositive;theviralloadwas,copiespermilliliter,andtheCD4+countwas7cellspermicroliter(referencerange,to).

人体免疫缺点病*抗体的探测呈阳性;病*载量为每毫升30万拷贝,CD4+计数为每微升7个细胞(参考界限至)。

InductiontherapywithliposomalamphotericinBandflucytosinewasstarted,andresolutionofsymptomsandnegativeresultsonCSFculturewerenotedafter2weeksoftreatment.

最先用脂质体两性霉素B和氟胞嘧啶施行开辟诊疗,诊疗2周后,病症获得缓和和脑脊液培植结束阴性。

Consolidationtherapywithfluconazolewasstarted,andantiretroviraltherapywaslaterprescribed.

最先用氟康唑施行牢固诊疗,随后抗逆转录病*诊疗。

摘自:

智我咋2

分享 转发
TOP
发新话题 回复该主题