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中华重症医学电子杂志 doi: 10.3877/cma.j.issn.2096-1537.2024.12.30-0005

病例报告

胎儿弯曲菌脑膜炎、血流感染的病例报告一例
张淋1, 孟新科1, 熊丽红1, 曾晶晶1, 李颖1,(), 王家泽1   
  1. 1.518025 深圳,深圳市第二人民医院重症医学科
  • 收稿日期:2024-01-05
  • 通信作者: 李颖

A case report of Campylobacter fetus meningitis and bloodstream infection

Lin Zhang1, Xinke Meng1, Lihong Xiong1, Jingjing Zeng1, Ying Li1,(), Jiaze Wang1   

  1. 1.Department of Critical Care Medicine, Shenzhen Second People's Hospital, Shenzhen 518025
  • Received:2024-01-05
  • Corresponding author: Ying Li
引用本文:

张淋, 孟新科, 熊丽红, 曾晶晶, 李颖, 王家泽. 胎儿弯曲菌脑膜炎、血流感染的病例报告一例[J/OL]. 中华重症医学电子杂志, doi: 10.3877/cma.j.issn.2096-1537.2024.12.30-0005.

Lin Zhang, Xinke Meng, Lihong Xiong, Jingjing Zeng, Ying Li, Jiaze Wang. A case report of Campylobacter fetus meningitis and bloodstream infection[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), doi: 10.3877/cma.j.issn.2096-1537.2024.12.30-0005.

胎儿弯曲菌脑膜炎罕见,易合并血流感染。本例胎儿弯曲菌脑膜炎、血流感染的患者在中枢神经系统表现为血管炎,导致误诊为自身免疫性脑炎。最终脑脊液、血培养出胎儿弯曲菌确诊,通过有效抗生素的治疗好转出院。

Campylobacter fetus meningitis is rare and easy to be complicated with bloodstream infection. This case of Campylobacter fetus meningitis and bloodstream infection showed vasculitis in the central nervous system, which was misdiagnosed as autoimmune encephalitis. Finally, Campylobacter fetus was diagnosed by culture of cerebrospinal fluid and blood, and discharged from hospital through the treatment of effective antibiotics.

图1 患者2023年5月1日头胸CT。红色标记代表出血灶,蓝色标记代表梗死灶,黄色标记代表脑白质变性
图2 患者2023年5月3日头颅MRI+MRA+SWI+DWI。红色标记代表出血灶,蓝色标记代表梗死灶 注:MRI为磁共振成像;MRA为磁共振血管造影;SWI为磁敏感加权成像;DWI为弥散加权成像
图3 患者2023年5月4日头颅MRV。箭头所示静脉窦、静脉未显影 注:MRV为磁共振静脉造影
图4 患者2023年6月6日头颅CT
图5 转入ICU前的诊疗线路 注:因坐标优化问题,以上坐标轴降钙素原数值为真实值的100倍,波动于0.07~0.98 ng/ml
表1 患者脑脊液检查结果
图6 :ICU的诊疗线路图 注:因坐标优化问题,以上坐标轴降钙素原数值为真实值的100倍,波动于0.03~0.45 ng/ml
图7 成人患者细菌性脑膜炎的临床表现
表2 患者病原体检出情况
图8 大肠埃希菌的药敏报告
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