系统性红斑狼疮合并烟曲霉菌脑脓肿2例  

Systemic lupus erythematosus combined with Aspergillus fumigatus brain abscess in 2 cases

作　　者：金世杰 郭晓鹏[1] 邢浩 马文斌[1] 王裕[1] Jin Shijie;Guo Xiaopeng;Xing Hao;Ma Wenbin;Wang Yu(Department of Neurosurgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院神经外科,北京100730

出　　处：《中华神经科杂志》2022年第12期1413-1418,共6页Chinese Journal of Neurology

摘　　要：系统性红斑狼疮(SLE)合并烟曲霉菌脑脓肿较为罕见,需要和细菌性脑脓肿及神经精神狼疮进行鉴别。文中报道2例手术确诊SLE合并烟曲霉菌脑脓肿的病例。例1为34岁女性,诊断SLE 6个月后出现抽搐及意识障碍,首次住院时因为影像学阴性被诊断为神经精神狼疮,出院后复查头颅磁共振成像发现脓肿样信号。例2为20岁男性,诊断SLE 3年后出现高热、抽搐及意识障碍,头颅影像学表现为脓肿样信号。2例患者脑脊液病原学均阴性,通过脓肿切除或引流病理确诊为烟曲霉菌脑脓肿,经予伏立康唑治疗后症状缓解、病灶消退。Systemic lupus erythematosus(SLE)complicated with Aspergillus fumigatus brain abscess is rare and needs to be differentiated from bacterial brain abscess and neuropsychiatric lupus.This article reports 2 cases of surgically diagnosed SLE combined with Aspergillus fumigatus brain abscess.The first patient was a 34-year-old woman.Six months after the diagnosis of SLE,she developed convulsions and unconsciousness.She was diagnosed as neuropsychiatric lupus at the first hospitalization because of negative imaging.After discharge,repeated head magnetic resonance imaging revealed abscess-like signals.The second patient,a 20-year-old male,developed high fever,convulsions,and unconsciousness 3 years after the diagnosis of SLE,and head imaging showed an abscess-like signal.The etiology of the cerebrospinal fluid of the 2 patients was both negative,and the Aspergillus fumigatus brain abscess was diagnosed by pathology through abscess resection or drainage.After treatment with voriconazole,the symptoms were relieved and the lesions were subsided.

关 键 词：红斑狼疮 系统性 曲霉菌 烟 脑脓肿 中枢神经系统真菌感染 神经精神狼疮 

分 类 号：R593.241[医药卫生—内科学] R519[医药卫生—临床医学]