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Lancet:脑囊虫病致儿童死亡-案例报道

2016-05-09 Mechront 译 MedSci原创

患者男,10岁,因1小时前全面性强直阵挛发作就诊。既往癫痫、头痛伴发热史3年。使用苯妥英钠(5mg/kg bid)治疗。就诊急诊时,患者已经心脏骤停(呼吸 5次/分,心率40次/分,收缩压50 mmHg,脉搏微弱,毛细血管再充盈 >15秒)。患者无意识(GCS: 3/15),双侧瞳孔散大无反应。心肺复苏等一系列抢救后,宣布患者死亡。尸检:大脑冠状切面显示双侧脑室腔塌陷,脑皮质广泛水肿,皮质下

患者男,10岁,因1小时前全面性强直阵挛发作就诊。

既往癫痫、头痛伴发热史3年。使用苯妥英钠(5mg/kg bid)治疗。

就诊急诊时,患者已经心脏骤停(呼吸 5次/分,心率40次/分,收缩压50 mmHg,脉搏微弱,毛细血管再充盈 >15秒)。患者无意识(GCS: 3/15),双侧瞳孔散大无反应。

心肺复苏等一系列抢救后,宣布患者死亡。

尸检:大脑冠状切面显示双侧脑室腔塌陷,脑皮质广泛水肿,皮质下可见大小不同的众多脑实质囊肿,一些可见幼虫。



镜检:囊肿内可见幼虫和分解物,以及间质沉积、纤维化、增生和坏死。



脑囊虫病是由寄生虫(猪绦虫为主)所传染的一种顽固性颅脑内疾病。该病约占囊虫病的80%以上。是由于口服了猪肉绦虫虫卵,发育成囊尾蚴,经消化道穿出肠壁进入肠系膜小静脉,再经体循环而到达脑膜、脑实质以及脑室内。患此病后脑组织及大脑中枢损伤严重,头疼、浑身无力、肢体运动障碍,最严重的是继发癫痫,视物不清,甚至失明,再甚者就诸如本案例中的死亡。

原始出处:

Nelly Gonzalez,Maria Guadalupe Trevino,et al.Cysticercal encephalitis.The Lancet.DOI: http://dx.doi.org/10.1016/S0140-6736(13)60691-1

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    2017-01-17 howi
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    2016-08-29 ylzr123

    深入学习,好文值得点赞!

    0

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    2016-06-15 早茶月光

    有点可怕!一定要注意宝宝们的饮食了

    0

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    2016-05-16 lecoo

    囊虫病在牧区比较常见。

    0

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    2016-05-15 Lisa971

    这种疾病,早期发现,能有效挽救没?

    0

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    2016-05-14 吴教授

    有密集恐惧症

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2092192, encodeId=51e9209219275, content=<a href='/topic/show?id=5b9184e8598' target=_blank style='color:#2F92EE;'>#脑囊虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84785, encryptionId=5b9184e8598, topicName=脑囊虫病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Fri Oct 07 01:14:40 CST 2022, time=2022-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1828474, encodeId=604b18284e4fb, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jan 17 01:37:00 CST 2017, time=2017-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106934, encodeId=e096106934ee, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=89925, encodeId=855d899257a, content=有点可怕!一定要注意宝宝们的饮食了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160704/IMG577A7DF6CC7185344.jpg, createdBy=07531689549, createdName=早茶月光, createdTime=Wed Jun 15 10:08:00 CST 2016, time=2016-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85949, encodeId=40b5859495f, content=囊虫病在牧区比较常见。, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d1ab1619415, createdName=lecoo, createdTime=Mon May 16 00:23:00 CST 2016, time=2016-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85861, encodeId=da7d85861cb, content=这种疾病,早期发现,能有效挽救没?, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun May 15 11:15:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85764, encodeId=7b3985e64a6, content=有密集恐惧症, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170701/IMG595791009FB761316.jpg, createdBy=abd01695121, createdName=吴教授, createdTime=Sat May 14 22:40:00 CST 2016, time=2016-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85334, encodeId=7dd18533439, content=值得阅读,学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue May 10 12:51:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85098, encodeId=05078509887, content=这关这种病例报道, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 18:35:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 1dd8a7c5m95(暂无匿称)

    值得阅读,学习!

    0

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    2016-05-09 jaysppr

    这关这种病例报道

    0

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