Pharmaceutical Care for Anti-infective Therapy in One Patient with Neurobrucellosis Complicated by Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy
Objective:To analyze the pharmaceutical care process of anti-infective therapy in one patient with neurobrucellosis complicated by autoimmune glial fibrillary acidic protein astrocytopathy(GFAP-A),and provide a reference for the treatment of patients with such complex and rare diseases.Methods and Results:The patient visited the hospital due to"dizziness and weakness of both lower limbs for 4 days".Upon admission,the patient was preliminarily diagnosed with tuberculous meningitis based on the symptoms,laboratory tests and imaging results.The GFAP antibody test showed that the patient also had GFAP-A.After 10 days of anti-tuberculosis therapy,the patient's symptoms and related laboratory indicators were improved,and the patient was permitted to be discharged.However,the patient experienced headaches and fever again on the second day after discharge.Upon further inquiry,it was discovered that the patient had been engaged in lamb processing for a prolonged period of time.A serum and cerebrospinal fluid test for brucella antibodies was then performed,and the results were both positive.The patient was then diagnosed with brucella meningitis.Following consultation with the clinical pharmacist,the patient was prescribed doxycycline,rifampicin,and ceftriaxone for treatment.After 11 days,the patient's symptoms were improved and he was discharged from the hospital.The clinical pharmacist recommended that the discharge treatment regimen was adjusted to doxycycline+rifampicin+compound sulfamethoxazole.More than four months later,the patient's brain images showed significant improvement over the previous results.The results of the cerebrospinal fluid brucella antibody test were negative,and the headache and limb weakness had also alleviated,however,the results of the serum brucella antibody test were still positive.Conclusion:Neurobrucellosis was a relatively complex and serious disease.The treatment should be performed with sufficient dosage and duration.The involvement of clinical pharmacists can assist physicians in formulating more optimized anti-infective treatment regimens,and can also monitor the safety of medication in the process of pharmaceutical care to safeguard the safety and effectiveness of medication treatment for patients.
neurobrucellosisautoimmune glial fibrillary acidic protein astrocytopathyanti-infective therapypharmaceutical care
万方数据
维普
