潜在性多発性骨髄腫に合併した脳膿瘍の1例

A Case of Brain Abscess Associated with Asymptomatic Multiple Myeloma

Ⅰ．はじめに

　脳膿瘍は予後が悪く，後手にまわらないように抗生剤加療・膿瘍吸引・開頭手術などの積極的加療を要する．そのため，脳膿瘍の早期診断はもちろん，その菌体の早期確認や原疾患の早期発見も非常に重要である．今回われわれは壮年者脳膿瘍の術後に多発性骨髄腫と診断された1例を経験したので若干の文献的考察を加え，免疫低下患者における脳膿瘍と今回検出された特異な菌体について報告する．

A 55-year-old male was admitted to our hospital because of confusion and mild weakness of his left arm and leg. His condition had taken a gradual turn for the worse for several months. Computed tomography (CT) demonstrated a mixed density mass with multiple cysts and massive perifocal edema. Magnetic resonance imaging (MRI) demon-strated an irregular-shaped mass with multiple cysts sized 6×4×6cm in the temporal lobe, which manifested mixed signal intensity on both the T1 weighted image and the T2 weighted image. MRI also revealed massive perifocal edema and marked midline shift. Gd-DTPA study showed ring-like enhancement.