一例狒狒巴拉姆希阿米巴脑炎报告及文献复习  

Balamuthia amebic encephalitis:A case report and review

作　　者：奚玲如 罗利婷 李丹丹 刘碧梅 赖可元 刘志红 Xi Lingru;Luo Liting;Li Dandan;Liu Bimei;Lai Keyuan;Liu Zhihong(Department of Neurology,Guangdong Sanjiu Brain Hospital,Guangzhou Guangdong 510510,China;Department of Clinical labortory,Guangdong Sanjiu Brain Hospital,Guangzhou Guangdong 510510,China)

机构地区：[1]广东三九脑科医院神经内一科,广东广州510510 [2]广东三九脑科医院检验科,广东广州510510

出　　处：《中华临床实验室管理电子杂志》2024年第4期238-243,共6页Chinese Journal of Clinical Laboratory Management(Electronic Edition)

摘　　要：目的加深对狒狒巴拉姆希阿米巴脑炎(BAE)的认识,提高临床对该种疾病的早期诊治和护理水平。方法回顾分析1例BAE患者的诊疗及护理过程,包括临床资料、体格检查、实验室检查、影像检查、诊治护理经过及临床转归等病例资料。结果患者,女,9岁,因咳嗽、发热与神志不清就诊于外院,对症治疗无效后转入广东三九脑科医院治疗。入院查体、影像学检查结果均无特征性。行2次脑脊液病原宏基因组(mNGS)检测,均提示狒狒巴拉姆希阿米巴感染,与脑脊液常规、生物化学及细胞学检查结果相符。患者接受对症治疗与特殊护理,但因病情进展过快,于入院7 d后死亡。结论BAE临床表现缺乏特异性,脑脊液mNGS检测有助于疾病的诊断。由于该疾病尚无特效治疗方法,需要为患者定制专属的治疗与护理方案。Objective To deepen public understanding of Balamuthia amebic encephalitis(BAE)and improve early diagnosis,treatment,and care of this disease in clinical practice.Methods The diagnosis,treatment and care process of a patient with BAE were analyzed,including clinical data,physical examination,laboratory examination,imaging examination,diagnosis,treatment,care process and clinical regression.Results The 9-year-old female patient was admitted to another hospital with cough,fever and confusion,and was transferred to our hospital after ineffective symptomatic treatment.Admission physical examination and imaging findings were uncharacteristic.Two cerebrospinal fluid(CSF)metagenomic nextgeneration sequencing(mNGS)tests were performed.Both tests suggested Balamuthia mandrillaris amoeba infection,which was consistent with the results of routine,biochemical and cytological examination of the CSF.The patient died seven days after admission due to rapid progression of the disease despite symptomatic treatment and specialized care.Conclusion The clinical presentation of BAE lacks specificity,and CSF examination helps to diagnose the disease.Since there is no specific treatment for this disease,an exclusive treatment and care plan needs to be tailed to the individual patient.

关 键 词：狒狒巴拉姆希阿米巴 阿米巴脑炎 实验诊断 脑脊液检查 诊疗护理 

分 类 号：R47[医药卫生—护理学]