Ann Intern Med:注射污染的硬膜外类固醇制剂脑膜炎风险高,且伏立康唑有效

2012-11-23 高晓方 翻译 中国医学论坛报

  近期发生于美国的真菌性脑膜炎疫情,是因硬膜外注射被污染的类固醇制剂所致。美国学者对患者的早期临床表现和治疗应答情况进行了研究。结果表明,暴露于污染的硬膜外类固醇注射剂(ESI)患者具脑膜炎发病风险,且经验性伏立康唑治疗对多数患者有效。论文11月12日在线发表于《内科学年鉴》(Ann Intern Med)。    研究纳入暴露于污染ESI的住院患者172例。结果为,共13

  近期发生于美国的真菌性脑膜炎疫情,是因硬膜外注射被污染的类固醇制剂所致。美国学者对患者的早期临床表现和治疗应答情况进行了研究。结果表明,暴露于污染的硬膜外类固醇注射剂(ESI)患者具脑膜炎发病风险,且经验性伏立康唑治疗对多数患者有效。论文11月12日在线发表于《内科学年鉴》(Ann Intern Med)。 

  研究纳入暴露于污染ESI的住院患者172例。结果为,共131例接受腰穿,25例(19%)伴嗜中性粒细胞性脑膜炎,并启动伏立康唑单药治疗,10例后转为两性霉素B治疗。治疗第13天,CSF白细胞计数开始下降。MRI表现包括脑室炎、软脑膜强化、梗塞、出血和蛛网膜炎。患者CSF伏立康唑浓度约为血清50%。细菌培养结果为嘴突脐孢菌和枝孢菌。



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    2015-02-28 xiaoai5777

    不错的文章,学习了

    0

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