海南1例类鼻疽病表现为脑部病变合并继发癫痫的临床特征  

Clinical characteristics of one case of melioidosis with brain lesions and secondary epilepsy in Hainan

作　　者：吴彪[1] 郑婉婷 钟成望 王清滢 林灿灿 蔡佳芮 吴华[1] 贾杰[1] 肖莎 WU Biao;ZHENG Wan-ting;ZHONG Cheng-wang;WANG Qing-ying;LIN Can-can;CAI Jia-rui;WU Hua;JIA Jie;XIAO Sha(Department of Infection, Hainan General Hospital, The Affiliated Hainan Hospital of Hainan Medical University, Haikou 570311, China;Department of Environmental and Occupational Health, School of Public Health, Hainan Medical University, Haikou 571199, China)

机构地区：[1]海南省人民医院海南医学院附属海南医院感染科,海南海口570311 [2]海南医学院公共卫生学院环境卫生与职业医学教研室,海南海口571199

出　　处：《中国感染控制杂志》2020年第12期1129-1133,共5页Chinese Journal of Infection Control

基　　金：海南省重点研发项目(ZDYF2018113);海南省哲学社会科学2020年规划课题[HNSK(ZC)20-36];大学生省级创新训练项目(S202011810010)。

摘　　要：本文报告1例类鼻疽病少见的脑部病变病例合并继发癫痫,患者为54岁男性,水泥工,因“右髋疼痛10 d”、“癫痫发作”2次入院,经血培养检出假鼻疽伯克霍尔德菌,确诊为类鼻疽病,药敏试验显示对亚胺培南、复方磺胺甲口恶唑敏感,经头颅MRI证实右侧半卵圆中心、胼胝体及扣带回后部多发脑部病变。采取抗感染、器官功能支持等内科对症治疗,经过6个月的治疗,患者恢复良好。因此,类鼻疽病合并中枢神经系统疾病应及时做相关检查,包括头颅MRI,积极行细菌培养及药敏试验,长期规范的抗感染治疗以避免复发。One case of melioidosis associated with rare brain lesion and secondary epilepsy was reported,patient was admitted to a hospital twice because of“right hip pain for 10 days”and“epileptic seizure”,Burkholderia pseudomallei was isolated through blood culture,and was diagnosed as melioidosis,antimicrobial susceptibility testing showed that it was susceptible to imipenem and compound sulfamethoxazole,magnetic resonance imaging(MRI)of brain proved that it was multiple brain lesions in right centrum ovale,corpus callosum,and posterior cingulate gyrus.After 6 months of symptomatic medical treatment,including anti-infective treatment and organ function support,patient recovered well.Therefore,relevant examination should be conducted in time for melioidosis complicated with central nervous system diseases,including cranial MRI,active bacterial culture and antimicrobial susceptibility testing,as well as long-term standardized anti-infective treatment,so as to avoid recurrence.

关 键 词：类鼻疽病 假鼻疽伯克霍尔德菌 脑部病变 癫痫 

分 类 号：R754[医药卫生—皮肤病学与性病学]