关键词: hydrocephalus immunocompromised meningitis treatment pneumococcal meningitis ventriculitis

来  源:   DOI:10.7759/cureus.60800   PDF(Pubmed)

Abstract:
Meningitis, an infection of the meninges of the central nervous system (CNS), can advance quickly and carries a mortality rate reaching 30% among affected patients. It may become complicated by conditions such as hydrocephalus, ventriculitis, and cerebral abscess. Here, we describe a case of meningitis that was complicated by pyogenic ventriculitis and hydrocephalus in a patient with diffuse large B-cell lymphoma (DLBCL) who underwent chemotherapy and radiotherapy. The patient presented with acute change in mental status and high-grade fever, with few episodes of non-bloody vomiting. Blood culture and cerebrospinal fluid (CSF) culture grew Streptococcus pneumoniae, which was sensitive to ceftriaxone. CT scan of the head showed ventriculomegaly, pansinusitis, and a large left mastoid effusion. MRI of the brain showed layering in ventricles, hydrocephalus, and dural enhancement consistent with pachymeningitis. She was treated with ceftriaxone for 21 days with a meaningful outcome. She was discharged home with near-baseline mental capacity for further physical therapy.
摘要:
脑膜炎,中枢神经系统(CNS)的脑膜感染,可以迅速进展,在受影响的患者中死亡率达到30%。它可能会因为脑积水等情况而变得复杂,脑室炎,还有脑脓肿.这里,我们描述了一例在接受化疗和放疗的弥漫性大B细胞淋巴瘤(DLBCL)患者中并发化脓性脑室炎和脑积水的脑膜炎病例.病人出现精神状态急性改变及高烧,很少有非血性呕吐。血培养和脑脊液(CSF)培养生长肺炎链球菌,对头孢曲松敏感.头部CT扫描显示脑室增大,全鼻窦炎,还有大量的左乳突积液.脑部MRI显示心室分层,脑积水,硬脑膜增强与硬脑膜炎一致。她用头孢曲松治疗21天,结果有意义。她以接近基线的心理能力出院回家,接受进一步的物理治疗。
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