隐源性脑脓肿1例报道及文献回顾

Case Report of Cryptogenic Brain Abscess and Literature Review

目的:了解隐源性脑脓肿的临床特点,总结诊疗经验,提高临床诊断的准确性,降低早期误诊率。方法:回顾分析1例经成功诊断和治疗的隐源性脑脓肿患者的临床表现、影像学特点,并结合文献对诊疗经验进行总结。结果:隐源性脑脓肿临床表现不典型,无明确感染途径,予经验性抗感染治疗,颅内病灶完全吸收,据此该病例临床诊断成立。结论:隐源性脑脓肿因感染源不明,起病隐匿,症状不典型易误诊,链球菌、葡萄球菌和厌氧菌是常见病原体。需与颅内结核瘤、脑寄生虫、脑胶质瘤、脑转移瘤等相鉴别。

Aim： To explore the clinical characteristics, accurate diagnosis, and efficient therapy of cryptogenic brain abscess. Methods： Clinical characteristics, laboratory data and successful therapy were described in detail, and the literature was reviewed. Results： The clinical manifestation was atypical in this case, no definite source of infection was identified, and no positive bacterial data was gained. However, accurate and timely clinical diagnosis and experiential treatment were very successful, so the diagnosis was verified eventually. Conclusion： Cryptogenie brain abscess has no apparent source of infection, clinical presentation is atypical, often to be misdiagnosed. Cryptogenic brain abscess needs to be differentiated by intracranial tumor, brain metastasis, intracranial tuberculoma, intracranial parasites. The most common pathogenic microorganism is streptococcus, staphylococcus aureus and anaerobic organism.