艾滋病合并伤寒沙门菌硬膜下脓肿一例  

AIDS complicated with Salmonella Typhi subdural abscess:a case report

作　　者：李翔 杞敏 付旭文 李海雯 陈海云 Li Xiang;Qi Min;Fu Xuwen;Li Haiwen;Chen Haiyun(The Third People Hospital of Kunming City/Yunnan Clinical Medical Center for Infectious Diseases,Kunming 650041,China)

机构地区：[1]昆明市第三人民医院/云南省传染性疾病临床医学中心,昆明650041

出　　处：《新医学》2024年第3期238-242,共5页Journal of New Medicine

基　　金：云南省科技厅科技计划项目(202001BA070001-194);昆明市卫生科研课题项目(2022-09-01-001)。

摘　　要：硬膜下脓肿是指硬脑膜与蛛网膜下腔之间的脓肿,常由葡萄球菌、链球菌等引起,伤寒沙门菌引起的硬膜下脓肿罕见。该文报道了一例艾滋病患者,表现为发热、头痛的硬膜下脓肿,血培养、脑脊液高通量测序(NGS)均提示伤寒沙门菌感染,予基于药物敏感试验的敏感抗生素治疗结合外科引流的方法而治愈,引流物培养出伤寒沙门菌。术后4个月随访,患者症状消失,影像学无异常。该文提示,伤寒沙门菌引起的颅内感染罕见,可见于免疫功能低下人群,血培养、脓液培养和NGS对于鉴别该病原体感染有重要的价值,确诊后选用敏感抗生素结合外科治疗,可取得良好疗效。Subdural abscesses are located between the dura mater and the subarachnoid space,which are primarily caused by Staphylococci and Streptococci,etc.Subdural abscesses caused by Salmonella Typhi are extremely rare.In this article,a patient with acquired immunodeficiency syndrome(AIDS)presented with a subdural abscess with fever and headache.Blood culture and next-generation sequencing(NGS)of cerebrospinal fluid were indicative of Salmonella Typhi infection.He was treated with sensitive antibiotics based on drug sensitivity testing combined with surgical drainage,and Salmonella Typhi was cultured in the drainage sample.During 4-month postoperative follow-up,relevant symptoms were mitigated and imaging examination results were normal.This case prompts that intracranial infection caused by Salmonella Typhi is extremely rare,which can occur in immunocompromised population.Blood culture,pus culture and NGS are of significant value in differential diagnosis of Salmonella Typhi infection.After the diagnosis is confirmed,sensitive antibiotics combined with surgical treatment can achieve high efficacy.

关 键 词：获得性免疫缺陷综合征 伤寒沙门菌 硬膜下脓肿 影像诊断 

分 类 号：R512.91[医药卫生—内科学] R742.9[医药卫生—临床医学]