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目的总结中枢神经系统白色念珠菌感染3例患儿的临床特征、影像学特点,为进行准确的临床诊断提供依据。方法总结中枢神经系统白色念珠菌感染3例患儿的临床表现、实验室检查、影像学特征、治疗和随访情况,并结合文献复习进行分析。结果 1 3例患儿在消化道手术后、全胃肠外营养、外周中心静脉置管输液的情况下,出现血液白色念珠菌感染;2 3例患儿脑脊液常规改变为白细胞总数正常,脑脊液生化糖含量降低,蛋白含量升高或正常;3 3例患儿头颅MRI均有异常信号改变。结论 1消化道手术后,合并有营养不良,尤其是接受外周中心静脉置管的新生儿或婴儿,均需高度警惕中枢神经系统白色念珠菌感染;2中枢神经系统白色念珠菌感染脑脊液改变不典型时,行头颅MRI检查,尤其是增强FLAIR序列有助于临床诊断;3多发微小脓肿可能是新生儿中枢神经系统白色念珠菌感染的重要特征性病理改变。
Objective To summarize the clinical features and imaging features of 3 cases of Candida albicans infection in the central nervous system and provide the basis for accurate clinical diagnosis. Methods The clinical manifestations, laboratory tests, imaging features, treatment and follow-up of 3 cases of Candida albicans infection in the central nervous system were summarized and analyzed with literature review. Results 13 cases of children with gastrointestinal Candida albicans infection after gastrointestinal surgery, total parenteral nutrition, peripheral venous catheter infusion; 23 cases of children with cerebrospinal fluid routine changes to the normal total number of leukocytes, cerebrospinal fluid biochemistry Sugar content decreased, protein content increased or normal; 3 patients with abnormal cranial MRI signal changes. Conclusions 1 After gastrointestinal surgery, malnutrition with malnutrition, especially in neonates or infants who received peripheral central venous catheterization, should be highly vigilant against central Candida albicans infection of the central nervous system. 2 Cerebrospinal fluid changes in the central nervous system caused by Candida albicans are not typical When cranial MRI examination, especially to enhance the FLAIR sequence is helpful for clinical diagnosis; 3 multiple small abscess may be neonatal central nervous system Candida albicans infection is an important characteristic pathological changes.