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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Mycobacterium chimaera encephalitis following cardiac surgery in three adult immunocompetent patients: first detailed neuropathological report
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Mycobacterium chimaera encephalitis following cardiac surgery in three adult immunocompetent patients: first detailed neuropathological report

机译：三颅杆菌脑膜炎患者在三个成人免疫活性患者中的心脏手术：第一个详细的神经病理报告

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摘要

Non-tuberculous mycobacterium encephalitis is rare. Since 2013, a global outbreak of Mycobacterium chimaera infection has been attributed to point-source contamination of heater cooler units used in cardiac surgery. Disseminated M. chimaera infection has presented many unique challenges, including non-specific clinical presentations with delays in diagnosis, and a high mortality rate among predominantly immunocompetent adults. Here, we describe three patients with fatal disseminated Mycobacterium chimaera infection showing initially non-specific, progressively worsening neurocognitive decline, including confusion, delirium, depression and apathy. Autopsy revealed widespread granulomatous encephalitis of the cerebrum, brain stem and spinal cord, along with granulomatous chorioretinitis. Cerebral involvement and differentiation between mycobacterial granulomas and microangiopathic changes can be assessed best on MRI with contrast enhancement. The prognosis of M. chimaera encephalitis appears to be very poor, but might be improved by increased awareness of this new syndrome and timely antimicrobial treatment.
机译：非结核性的分枝杆菌性脑炎是罕见的。自2013年以来，全球爆发了Chimaera感染的爆发，归因于心脏手术中使用的加热器冷却器单元的点源污染。传播的M.Chimaera感染呈现出许多独特的挑战，包括诊断延迟的非特异性临床介绍，主要是免疫活性成年人的高死亡率。在这里，我们描述了三名致命播散的乳杆菌感染患者，显示出初始非特异性，逐渐恶化的神经认知下降，包括混乱，谵妄，抑郁和冷漠。尸检揭示了大脑，脑干和脊髓的广泛肉芽肿性脑炎，以及肉芽肿性胆体腺炎。脑细菌肉芽肿和微盲管变化之间的脑受累和分化可以最好地评估MRI，具有对比增强。 M.Chimaera脑炎的预后似乎非常差，但可能提高了这种新综合征和及时抗菌治疗的认识。

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