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本文报告一例疑为单纯疱疹脑炎(HSE)而脑活检确诊为中枢神经系统藻菌病。患者女性,26岁,进行性发展发热、头痛、恶心、呕吐、嗜睡、复视、言语困难至意识模糊六日。既往有哮喘和过敏性鼻炎史,曾服避孕药,偶尔使用地塞米松磷酸钠喷鼻。检查发现体温39℃,轻度颈项强直,缄默、不能听从命令或模仿手势,眼底双视乳突水肿,左侧第6颅神经麻痹,左侧痉挛性偏瘫,右偏侧痛觉减退。CT脑扫描示两半球深部白质密度减低,用对比剂后有界限不明的增强区,颅骨平片及CT示鼻窦正常。腰穿压力280mmH_2O,CSF检查:RBC50个/mm~3,WBC290个/mm~3,其中单核占57%,多核占43%,糖65mg/dl,蛋白88mg/dl,革兰氏染色及细菌培养(一)。EEG呈弥散性慢波,无痫性放电。同位
This article reports a case of suspected herpes simplex encephalitis (HSE) and brain biopsy diagnosed as CNS phytoplasma. Female, 26 years old, progressive development Fever, headache, nausea, vomiting, lethargy, diplopia, speech difficulties to confusion for six days. Past history of asthma and allergic rhinitis, had contraceptives, and occasionally use dexamethasone sodium phosphate nasal spray. Examination found that body temperature 39 ℃, mild neck stiffness, silence, can not obey orders or imitation gestures, fundus papilledema, left 6 cranial nerve palsy, left spastic hemiplegia, right side of the pain reduction. CT brain scans showed decreased hemoglobin density in the deep hemispheres, contrast-enhanced areas with unclear boundaries, skull plain radiographs, and normal sinusoids. Waist pressure 280mmH_2O, CSF examination: RBC50 / mm ~ 3, WBC290 / mm ~ 3, of which 57% were mononuclear, 43% were multi-nuclear, 65mg / dl of sugar, 88mg / dl of protein, Gram stain and bacteria Training (a). EEG diffuse slow wave, no epileptic discharge. Same place