Listeria rhombencephalitis mimicking acute disseminated encephalomyelitis in a patient without predisposing medical conditions
Listeria rhombencephalitis mimicking acute disseminated encephalomyelitis in a patient without predisposing medical conditions
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李斯特菌菱形脑炎类似于患者的急性播散性脑脊髓炎，且无诱发性医疗条件
DOI：
10.1007/s13365-020-00896-3
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发表时间：
2020
影响因子：
3.2
通讯作者：
Shifang Ding
中科院分区：
文献类型：
--
作者：
Hongna Yang;Cuilan Wang;Hao Wang;Shifang Ding
李斯特菌菱脑炎 (L.rhombencephalitis) 是一种罕见的中枢神经系统感染，由单核细胞增生李斯特菌 (LM) 引起。它经常发生在免疫功能健全的个体身上。在这里，我们描述了一名没有病史的 45 岁女性患者的病例，她出现高烧、头痛和局灶性神经系统表现。由于临床症状、急性临床病程和神经影像学检查，她最初被经验诊断为急性播散性脑脊髓炎（ADEM）。然而，脑脊液（CSF）的生化分析对 ADEM 的诊断提出了质疑。 L.rhombencephalitis 的最终诊断是基于 LM 的脑脊液培养。因此，对于早期乳酸显着升高、脑脊液中红细胞中度增加、并伴有脑干快速进展的神经功能障碍的患者，应优先根据经验考虑菱形脑炎。
Listeria rhombencephalitis (L.rhombencephalitis) is an uncommon form of central nervous system infection caused by Listeria monocytogenes (LM). It often occurs to immunocompetent individuals. Here, we described the case of a 45-year-old female patient without medical histories, who presented for high-grade fever, headache, and focal neurological manifestations. She was initially empirically diagnosed with acute disseminated encephalomyelitis (ADEM) because of clinical symptoms, acute clinical course, and neuroimaging. However, the biochemical analysis of cerebral spinal fluid (CSF) questioned the diagnosis of ADEM. The final diagnosis ofL.rhombencephalitis was based on CSF culture for LM. Thus,L.rhombencephalitis should be preferentially and empirically considered for a patient with significantly elevated lactic acid and moderately increased red cells in CSF at early time, accompanied with rapidly progressive neurological dysfunctions involved in the brain stem.