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患者,女性26岁,因“左侧颈静脉孔区脑膜瘤”在外院手术,术后并发颅内感染,治疗半年后2003年7月转入我院。查体:T 37.8℃,神清,萎靡,瞳孔正常,左耳后见手术切口疤痕,左侧面瘫,右眼裂变小,左眼球外展受限,右额部接一侧脑室外引流管,四肢肌力、肌张力基本正常。血常规:WBC 16.2×10~9/L,N 85.4%。脑脊液常规:潘氏试验(-),细胞数0.14 G/L,细胞分类:中性72%,淋巴28%。MRI 示:术后颅脑内多发感染病灶,部分脓肿形成。入院后按外院治疗方案治疗一周,效果不明显,患者脑脊液引流量每日250～300 ml,并出现絮状沉淀物,经我院脑脊液培养证实为:产吲哚黄杆菌,对头孢吡圬(马斯平)敏感,遂给予马斯平静脉及鞘内注射,一周后患者精神明显好转,体温降至正常,脑脊液引流量减少,并转为清亮。治疗一月后
Patients, 26-year-old female, because of “left jugular foramen region meningioma ” surgery in the outer hospital, postoperative intracranial infection, treatment six months later in July 2003 transferred to our hospital. Physical examination: T 37.8 ℃, Shen Qing, apathetic, normal pupil, see the left ear after surgical incision scarring, paralysis on the left side, right fissure is small, limited left eyeball abduction, Limb muscle strength, muscle tone was normal. Blood: WBC 16.2 × 10 ~ 9 / L, N 85.4%. Cerebrospinal fluid routine: Pan test (-), the number of cells 0.14 G / L, cell classification: 72% of the neutral, lymphatic 28%. MRI showed: multiple intracranial lesions after infection, the formation of some abscesses. After admission, according to the treatment plan outside the hospital for a week, the effect is not obvious, the patient’s cerebrospinal fluid drainage 250 ~ 300 ml per day, and the emergence of flocculent sediment, confirmed by our hospital cerebrospinal fluid culture: indolenobacter indomethacin, cefpirome Masping) sensitive, then given Masi vein and intrathecal injection, a week after the patient’s mental improved significantly, body temperature dropped to normal, reduced cerebrospinal fluid drainage, and to clear. After one month of treatment