曲霉菌脑病的临床及影像学特点  

Clinical and imaging features of aspergillus encephalopathy

作　　者：刘清[1] 尹晟[1] 易良杰[1] 孙艳[1] 唐纪文 

机构地区：[1]惠州市中医医院神经内科,516001

出　　处：《临床神经病学杂志》2014年第2期130-132,共3页Journal of Clinical Neurology

摘　　要：目的探讨曲霉菌脑病的临床及影像学特点。方法对本院1例曲霉菌脑病患者的临床资料及文献报道的7例曲霉菌脑病患者的资料进行回顾性分析。结果 8例曲霉菌脑病中6例有基础疾病,使用抗生素和/或糖皮质激素或伴粒细胞减少。患者多以发热和/或头痛为首发症状,临床表现为不规则低至中度发热7例、头痛8例、偏瘫7例、意识障碍4例、癫痫2例。MRI检查有5例为多发性脑脓肿,1例为脑膜炎,1例为炎性血栓形成,1例为脑脓肿并发颅内出血。4例经多次CSF、脓液培养才检出曲霉菌,4例经手术病理检出曲霉菌。5例经手术引流或切除脓肿和伏立康唑等治疗后痊愈,2例治疗无效死亡,1例放弃治疗死亡。结论曲霉菌脑病在多种易感因素下更易诱发,临床表现以发热、头痛、偏瘫和意识障碍为主,其MRI检查具有一定的特征性。Objective To explore the clinical and imaging features of aspergillus encephalopathy （AE）. Methods The clinical data of 1 AE patient who treated in our hospital and other 7 AE patients from literatures were analyzed retrospectively. Results Among all the 8 AE patients, 6 cases had underlying diseases, using antibiotics and/or glucoeorticoids, or with granulocytopenia. The patients were onset as fever and/or headache. The clinical manifestation were irregular low to medium fever in 7 cases, headache in 8 cases, hemiplegia in 7 cases, disturbance of consciousness in 4 cases and epilepsy in 2 cases. MRI showed multiple brain abscesses in 5 cases, meningitis in 1 case, inflammatory thrombosis in 1 case and brain abscesses complicated with intracranial hemorrhage in 1 case. Aspergillus were finally checked out by seveary times CSF or pus cultivate in 4 cases, and were found by operation and pathology in the other 4 cases. There were 5 cases cured by operation drainage or resection of the abscess treated with medicine of voriconazole, 2 cases died of invalid treatment, 1 case died of abandoning treatment. Conclusions AE may easily induced by various predisposing factors, and the main clinical manifestations are fever, headache, hemiplegia and disturbance of consciousness. It＇s MRI detection has a certain characteristic.

关 键 词：曲霉菌脑病 临床 影像学 特点 

分 类 号：R742.9[医药卫生—神经病学与精神病学]