An adult case of cerebral malakoplakia successfully cured by treatment with antibiotics, bethanechol and ascorbic acid
An adult case of cerebral malakoplakia successfully cured by treatment with antibiotics, bethanechol and ascorbic acid
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DOI：
10.1016/j.jns.2014.05.006
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发表时间：
2014-07-15
影响因子：
4.4
通讯作者：
Fujiki, Minoru
中科院分区：
文献类型：
--
作者：
Fudaba, Hirotaka;Ooba, Hiroshi;Fujiki, Minoru
脑软斑是一种非常罕见的慢性炎症性疾病。我们在此报道一名 49 岁女性的病例，她出现缓慢进展的言语障碍和右侧偏瘫。计算机断层扫描和磁共振成像显示左侧岛叶、丘脑和基底神经节有不规则的强化肿块病变，并有许多散在的钙化区域。组织病理学上，活检标本显示嗜碱性层状包涵体和细胞内和细胞外结石球，通常具有典型的靶样外观（米氏小体）。抗生素、氨甲酰甲胆碱和抗坏血酸治疗改善了她的症状，并减少了异常钙化和强化。从患者的临床病程和神经放射学图像表现来看，脑软斑与脑肿瘤相似；然而，通过药物治疗成功治愈了。该病例证明脑软斑的发病机制与细菌感染密切相关，并且药物治疗对该病是有效的。 (C) 2014 Elsevier B.V. 保留所有权利。
Cerebral malakoplakia is a very rare chronic inflammatory disease. We herein report the case of a 49-year-old female who presented with a slowly progressive speech disturbance and right hemiparesis. Computed tomography and magnetic resonance imaging showed irregular enhanced mass lesions with numerous scattered areas of calcification in the left insula, thalamus and basal ganglia. Histopathologically, the biopsy specimen showed basophilic laminated inclusion bodies and intracellular and extracellular calculospherules, usually with a typical targetoid appearance (Michaelis-Gutmann bodies). Treatment with antibiotics, bethanechol and ascorbic acid improved her symptoms in association with a decrease in the abnormal calcification and enhancement. The cerebral malakoplakia mimicked a brain tumor in terms of the patient's clinical course and neuroradiological image findings; however, it was successfully cured with medical treatment. This case provides evidence that the pathogenesis of cerebral malakoplakia is deeply tied to bacterial infection and that medical treatment is effective in cases of this disease. (C) 2014 Elsevier B.V. All rights reserved.