儿童福氏耐格里阿米巴脑膜脑炎1例

A case of primary amoebic meningoencephalitis in children caused by Naegleria fowleri

患儿男,14岁,无明显诱因持续高热3 d,昏迷伴抽搐,临床初诊中枢神经系统感染,病原体不明。患儿脑脊液细胞学湿片直接镜检发现形态各异活跃阿米巴样运动滋养体;经瑞氏姬姆萨染色,高倍镜下见阿米巴滋养体。根据患儿脑脊液实验室细胞形态学结果、影像资料及临床症状,诊断为儿童原发性阿米巴脑膜脑炎。经感染病原靶向高通量基因检测和阿米巴原虫种特异性PCR验证,明确为福氏耐格里阿米巴原虫感染。给予及时抗阿米巴原虫等相关治疗,50 d后死亡。

A 14-year-old boy presented with coma and convulsion following a 3-day high fever of unknown origin was initially diagnosed with a central nervous system infection with uncertain pathogen.Direct microscopic examination of wet slides of cerebrospinal fluid cytology revealed active amoeboid trophozoites with different shapes.The amoeba trophozoite could be seen at high magnification after Wright′s-Giemsa staining.A diagnosis of primary amoebic meningoencephalitis was made according to the cellular morphology results of the cerebrospinal fluid,imaging data,and clinical symptoms.After high-throughput gene detection targeting the infection pathogen and specific PCR verification of amoeba species,it was confirmed that the infection was caused by Naegleria fowleri.Timely antiamoebic treatment and other related treatments were implemented,but the patient progressed to brain death after 50 days,leading to the discontinuation of treatment by the family.