摘要
目的:提高对免疫缺陷人群患弓形虫脑病的诊断水平和加强对经验性治疗的认识。方法:结合1例艾滋病合并弓形虫脑病患者的临床资料及文献复习,对本病的临床表现、实验室检查、影像学检查、诊断、鉴别诊断和治疗进行分析。结果:该患者在艾滋病基础上合并弓形虫脑病,临床症状为头痛、视物模糊、癫痫发作;实验室检查血弓形虫抗体IgG阳性;头颅MRI表现多发结节,增强后病灶呈不规则强化伴周围水肿;因难以取得病理,诊断主要依赖临床;经验性使用复方磺胺甲噁唑(SMZ/TMP)及阿奇霉素抗弓形虫治疗后,患者症状明显缓解。结论:弓形虫脑病是免疫缺陷患者常见的中枢神经系统机会性感染之一,正确诊断和及时治疗对于挽救患者的生命非常重要。
Objective： To improve diagnostic level of toxoplasmic encephalitis in the immune deficiency patients and attach importance to its empirical therapy. Methods： Combining with clinical data of one case with toxoplasmic encephalitis and AIDS and reviewing related literatures, we analyzed the clinical manifestations, laboratory examination, imaging examination, diagnosis, differential diagnosis and treatment. Results： Clinical symptoms of the patient with toxoplasmic encephalitis and AIDS were headache, visual blurring, epilepsy; Toxoplasma gondii IgG was positive. Head MRI showed multiple nodules. The lesion was edema and inhomogeneous enhancement on enhance MRI. It was difficult to obtain pathological tissue, so diagnosis mainly depended on doctor＇s clinical experience. The patient symptoms were obviously alleviate after SMZ/TMP and azithromycin were empirically used. Conclusion： Toxoplasmic encephalitis is a common opportunistic infection of central nervous system in immune defect patient. Correct diagnosis and treatment in time to save the life of the patient is very important.
出处
《现代医学》
2013年第5期307-311,共5页
Modern Medical Journal
关键词
弓形虫脑病
获得性免疫缺陷综合征
复方磺胺甲噁唑
阿奇霉素
toxoplasmic encephalitis
acquired immune deficiency syndrome
compound sulfamethoxazole
azi-thromycin
