- 期刊
Meningogenic Labyrinthitis Complicated by Streptococcus Pneumoniae Septicemia in a Systemic Lupus Erythematosus Adult: A Case Report
紅斑性狼瘡成人併發肺炎雙球菌敗血症引起的腦膜炎續發細菌性迷路炎－病例報告
摘要
神經性聽力喪失是細菌性腦膜炎之併發症。大部分的病人為兒童。成年人的腦膜炎發生機率並不高而之後又併發感覺神經性聽力喪失的比率一般也認為遠低於兒童。細菌性腦膜炎後之感覺神經性聽力喪失為耳蝸受到侵犯所致。其路徑有三：從內聽道，經由血液來源，及耳蝸導水管。影像方面可能的發現有：在電腦斷層上可見耳蝸之鈣化，在核磁共振造影T2影像上，耳蝸之水信號減弱以及在核磁共振造影T1影像加顯影劑上，耳蝸會有異常的顯影。病人早期接受聽性腦幹反射檢查如果無反應，聽力一般不會恢復。抗生素加上類固醇治療對於聽力的改善或許會有幫助。本文報告一接受腹膜透析之紅斑性狼瘡病人在細菌性腦膜炎後併發不常遇見的兩側感覺神經性聽力喪失。我們同時瀏覽相關文獻並加以討論。
並列摘要
Sensorineural hearing loss can be a complication of bacterial meningitis. Most victims are in the pediatric age group. In adults, the incidence of meningitis is low, and the hearing impairment after meningitis seems to be even lower. Sensorineural hearing loss in meningitis may be attributable to cochlear involvement of infection through various routes including the internal auditory canal, hematogenous spread, or through the cochlear aqueduct. Imaging findings may include a slight reduction in the fluid signal within the cochlea on T2-weighted magnetic resonance (MR) images and cochlear enhancement on gadolinium-enhanced T1-weighted images, or ossification of the cochlear with computed tomography (CT) later in the recovery stage. Patients who have no response to the auditory brainstem evoked potential response initially may never recover the hearing loss. Antibiotics combined with dexamethasone may offer some benefit for certain cases. In this report, we present a systemic lupus erythematosus adult who was on continuous ambulatory peritoneal dialysis and who developed meningogenic bacterial labyrinthitis. Important related articles are also reviewed.
延伸閱讀
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