散发性嗜酸性粒细胞增多性脑膜炎的临床特点(附3例报告)

Clinical features of sporadic eosinophilic meningoencephalitis(report of 3 cases)

目的探讨散发性嗜酸性粒细胞增多性脑膜炎的临床特点。方法回顾性分析3例散发性嗜酸性粒细胞增多性脑膜炎患者的临床资料。结果 3例患者均为急性起病,其中2例有明确吃生鱼史,潜伏期分别为7 d和2个月。3例均表现为发热、头痛,2例有躯体疼痛。3例患者外周血及CSF嗜酸性粒细胞比例及计数均增多。1例广州管圆线虫、弓形虫、肝吸虫及囊虫抗体阳性。MRI示左侧颞叶斑片状长T1、长T2异常信号。给予阿苯达唑驱虫、糖皮质激素等治疗后患者基本恢复正常,未遗留后遗症。结论嗜酸性粒细胞增多性脑膜炎临床特点均以发热、头痛或伴躯体疼痛为主,周围血象及CSF中嗜酸性粒细胞比例及计数升高,治疗效果佳,预后好。

Objective To investigate clinical features of sporadic eosinophilic meningoencephalitis. Methods The clinical data of 3 patients with eosinophilic meningoencephalitis were analyzed retrospectively. Results There was acute onset in all the 3 patients. Two cases had history of eating raw fresh with a latency of 7 and 2 months respectively. All the 3 patients had fever and headache, and body pain was in 2 cases. Eosinophlic count was significantly increased in peripheral blood and CSF in all the patients. Sera antibodies against angiostrougylus cantonensis, toxoplasma gondii, liverfluke, cysticerus were positive in 1 case. MRI showed patchy shadows in left temporal lobe on high T, and high T2 signal. All the patients were received albendazole and glncocorticosteroid therapy, and almost returned to normal without any sequela. Conclusions The clinical features of eosinophilic meningoencephalitis are fever, headache or body pain. eosinophlic count in peripheral blood and CSF are significantly increased. Therapeutic effects and prognosis of this disease are favourable.