鼻疽奴卡菌脑膜炎一例

目的 探讨鼻疽奴卡菌脑膜炎的临床表现及诊断要点,为临床早期诊疗该类疾病提供依据,以改善患者预后.方法 分析了1例2019年8月于首都医科大学宣武医院就诊、临床表现酷似结核性脑膜炎、最终经脑脊液宏基因组二代测序检测确诊的鼻疽奴卡菌脑膜炎患者的临床信息、脑脊液检查、头颅磁共振成像(MRI)检查等资料,并结合文献报道比较两种...

Nocardia farcinica meningitis: A case report

Objective To explore the clinical manifestations and diagnosis of nocardia meningitis,and to provide the basis for clinical diagnosis and treatment of this disease.Methods The detailed clinical manifestations,cerebrospinal fluid examination,imaging characteristics,metagenomics next-generation sequencing were analyzed in a case of nocardia meningitis similar to tubercular meningitis in symptomatology.The differences between the two different meningitis were compared in combination with the literature review.Results The patient is a 50-year-old male,the main clinical manifestations are headache and fever.Lumbar puncture indicates that white blood cell count and protein increased,glucose and chloride reduced.Metagenomic next-generation sequencing of cerebrospinal fluid from patient results nocardia farcinica.After combined treatment with sulfonamide and ceftriaxone,the symptoms,cerebrospinal fluid and magnetic resonance imaging returned to normal.Conclusions The possibility of nocardia infection should be considered for meningitis with an immunosuppressed CSF similar to tuberculosis.Pathogen testing is the only gold standard for diagnosis,including culture positivity or metagenomics next-generation sequencing of pathogenic microorganisms.Early diagnosis and early application of sulfonamide with sufficient dose and full course of treatment can significantly improve the prognosis.