奴卡氏菌性脑脓肿的临床特点(附1例报告)

Clinical features of nocardia brain abscess( report of 1 case)

目的探讨奴卡氏菌性脑脓肿的临床特点。方法回顾性分析1例奴卡氏菌性脑脓肿患者的临床资料。结果本例患者急性起病,以发现右肩肿块后继发头痛、左侧肢体无力为主要症状。既往有"特发性血小板减少性紫癜"病史,长期口服激素、免疫抑制剂治疗。头颅MRI示右侧脑干及左侧顶叶可见圆形占位;增强后呈环形强化。右肩肿块穿刺脓液培养示奴卡氏菌。结论奴卡氏菌性脑脓肿患者死亡率高,要重视病原学诊断与长期特异性抗感染治疗,必要时需结合手术治疗。

Objective To investigate the clinical characteristics of nocardia brain abscess. Methods The clinical data of 1 case of nocardia brain abscess was retrospectively analyzed. Results The patient was acute onset,with a bump on the right shoulder and presented headache,and weakness of the left side limb. The patient was diagnosed as idiopathic thrombocytopenic purpura,and received oral corticosteroids and immunosuppressive therapy.Brain MRI showed space-occupying lesions which showed ring enhancement in the right side of the brain stem and the left parietal lobe. The right shoulder bump was pierced and the pus was cultivated,then the nocardia was found.Conclusions The mortality rate of nocardia brain abscess is very high. The specific etiological diagnosis and longterm anti-infection treatment are very importment. Surgical intervention should be included when necessary.