人体感染狒狒巴拉姆希阿米巴脑炎1例报告  

Report of one case of Balamuthia mandrillaris encephalitis in Human

作　　者：李道佩[1] LI Dao-pei(Xiaolan People’s Hospital of Zhongshan City,Guangdong Province/The Fifth People’s Hospital of Zhongshan City,Zhongshan 528415,China)

机构地区：[1]广东省中山市小榄人民医院(中山市第五人民医院),中山528415

出　　处：《中国人兽共患病学报》2024年第7期696-700,共5页Chinese Journal of Zoonoses

摘　　要：目的探讨狒狒巴拉姆希阿米巴脑炎的临床特点、诊断方法和治疗策略。方法回顾性分析病例资料。结果患者入院时检查异常的指标有:呼吸道病原体IgM阳性,华大基因测序结果检出狒狒巴拉姆希阿米巴的检出序列数为55,脑脊液分析结果显示白细胞计数为371×10^(6)/L,蛋白定量为3321.4 mg/L,葡萄糖为2.33 mmol/L,氯化物为110 mmol/L,这些数据表明,患者存在严重感染症和免疫紊乱。经过6 d治疗,患者的病情虽有所好转,仍然危重。由于缺乏特效药物,预后极差,家属要求出院。结论狒狒巴拉姆希阿米巴脑炎是一种罕见但危险的疾病,临床表现多样,诊断难度较大,缺乏特效药物,治疗难度极大,预后极差。但对于疑似狒狒巴拉姆希阿米巴脑炎的患者,乃应早期进行综合性治疗,包括抗感染、免疫调节等治疗措施。This article reports a case of amoebic encephalitis caused by Balamuthia mandrillaris in a 76-year-old rural female patient,including clinical manifestations,laboratory examinations,and treatment results.This study explored the clinical characteristics,diagnostic methods,and treatment strategies for amoebic encephalitis caused by Balamuthia mandrillaris.A retrospective analysis of the patient's medical records was conducted.At admission,the patient's examination findings were abnormal,with positive IgM for respiratory pathogens,and 55 detected sequences of Balamuthia mandrillaris according to Huada Gene Sequencing.Cerebrospinal fluid analysis indicated a white blood cell count of 371×10^(6)/L,protein level of 3321.4 mg/L,glucose level of 2.33 mmol/L,and chloride level of 110 mmol/L,thereby indicating severe infection and immune disorders.After 6 days of treatment,the patient's condition had improved slightly but remained critical.Because of the lack of specific drug treatments,the patient’s prognosis was extremely poor,and her family requested discharge.Amoebic encephalitis caused by Balamuthia mandrillaris is a rare but dangerous disease with diverse clinical manifestations,difficult diagnosis,and lack of specific drugs,thus making treatment extremely difficult and leading to poor prognosis.For patients suspected of having amoebic encephalitis caused by Balamuthia mandrillaris,comprehensive treatment should be initiated early and should include anti-infection and immune regulation measures.

关 键 词：狒狒巴拉姆阿米巴脑炎 基因测序 脑脊液 低蛋白血症 低钾血症 高钠血症 

分 类 号：R382[医药卫生—医学寄生虫学]