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Recombinant human interferon-α-2b in the treatment of endometriosis research


Close the hospital. More than 1 year past history of hypertension, blood pressure, high 180/105mmHg (1mmHg = O.133kPa), continuous take, Cerebrospinal fluid rhinorrhea history of more than 1 year, not to attract attention, were not special treatment. A fall of more than 1 year before, but denied head trauma. Physical examination: body temperature 38.2 ℃, pulse 92 / min, breathing 21 times / min, blood pressure 150/104inmHg. Clear consciousness, lack of energy, acute tolerance,[link widoczny dla zalogowanych], stiff neck, Clinton sign positive, Brinell and positive signs. Lumbar puncture showed: CSF turbidity, pressure> 400mmH, O (1mmHO = 0.0098kPa). CSF General said: Yellow micromixing, Pan's test (++), glucose 0.5mmol / L, erythrocyte 0.8xlOg / L, WBC 2.52x109 / L, 0.67 multinucleated cells, lymphocytes 0.33. Urine bacterial culture of cerebrospinal fluid was identified as Actinobacillus, drug sensitivity test results and other multi-drug sensitive to ceftriaxone, ciprofloxacin intermediary. Blood: WBC 28.2x109 / L, neutrophils O. 883. Consider the cause of urinary Actinobacillus purulent meningitis. Ceftriaxone were given to the hospital, mannitol and other symptomatic treatment, hospital rounds and found the first 2 days patients out of clear fluid from the nose, liquid inspection confirmed as cerebrospinal fluid, CSF rhinorrhea asked that history has been 1 year, then in 3 days in stable condition after the first review of head CT showed: higher density shadow in the sphenoid sinus. Magnetic resonance imaging of brain in patients refused to further clarify the cause of cerebrospinal fluid rhinorrhea. Found for the selected antibiotic susceptibility test results, patient's condition gradually improved,[link widoczny dla zalogowanych], the first 4 days in patients with body temperature to normal,[link widoczny dla zalogowanych], routine cerebrospinal fluid on day 6 show review: colorless, transparent,[link widoczny dla zalogowanych], Pan's test (a), glucose 3.3mmol / L , RBC 0.03 × 109 / L, white blood cells (a), multinucleated cells (A), lymphocytes (a). CSF bacterial culture (a). The first l0 days outside the hospital were in a hurry to go to specialist for diagnosis and treatment of cerebrospinal fluid rhinorrhea, automatic discharge. Discharged patients with no fever, no nausea and vomiting, mild neck resistance, Clinton sign, Brinell sign (a 1. Fierce and patients lost to recurrence is unknown. 2 discussions purulent meningitis caused by common bacteria Staphylococcus aureus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, Cryptococcus neoformans, etc., but cerebrospinal fluid in the urine actinomycetemcomitans isolated and rare. urinary actinomycetemcomitans is a rare bacteria, Gram-negative, non-acid-fast filamentous bacteria, the growth needs of the blood containing 5% or 10% of the serum, in 5% CO environment, growing well,[link widoczny dla zalogowanych], 2O ℃ ~ 42oC could grow, the optimum temperature 35 ~ 37oC; eosin methylene blue agar plate does not grow. actinomycosis central nervous system are rare, and easy to misdiagnosis. ... In 1967, the discovery of the first angiography in 1 case after intracranial actinomycosis, has about dozens of cases of central nervous system at home and abroad system actinomycosis reported. This Actinobacillus patients suffering from meningitis in urine, cerebrospinal fluid rhinorrhea is a major incentive. cerebrospinal fluid is divided into traumatic and non-traumatic, and trauma are the most common, 50% of the disease in the 48h , 90% incidence in a month. small number of cases in the injury for several years or even longer after the cerebrospinal fluid. non-traumatic cerebrospinal fluid rhinorrhea, also known as spontaneous CSF rhinorrhea can be divided into high and normal pressure , 40-year-old as high age, a history of more than a cold, coughing, after sneezing or high tension. The cause of CSF rhinorrhea is not clear, need further examination. The clinical manifestations of patients with purulent meningitis with the performance of other similar Diagnosis was confirmed by culture and identification based on the results of cerebrospinal fluid. The key is to treat this case as soon as possible the experience of starting antibiotic therapy, drug sensitivity test results suggest that ceftriaxone-sensitive, so the treatment is effective. However, recurrence in patients be followed up. For the patients, active treatment Cerebrospinal fluid rhinorrhea is the key to prevent recurrence of meningitis.