克柔念珠菌致中枢神经系统感染个案报告

doi:10.3969/j.issn.1674-8115.2026.05.016

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (5): 688-692.doi: 10.3969/j.issn.1674-8115.2026.05.016

• 病例报告 • 上一篇

克柔念珠菌致中枢神经系统感染个案报告

邓园园¹^,², 袁媛³()

^1.甘肃中医药大学第一临床医学院，兰州 730000
^2.兰州大学第一医院东岗院区重症医学科，兰州 730000
^3.上海中医药大学附属龙华医院重症医学科，上海 200032

收稿日期:2025-11-07 接受日期:2026-03-09 出版日期:2026-05-15 发布日期:2026-05-15
通讯作者: 袁　媛，主任医师，博士；电子信箱：695203897@qq.com。
基金资助:
甘肃省高校教师创新基金(2023B-002);甘肃中医药大学研究生创新创业项目(2026CXCY-116);兰州大学第一医院院内基金(ldyyyn2021-52)

Case report of central nervous system infection caused by Candida krusei

Deng Yuanyuan¹^,², Yuan Yuan³()

^1.The First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou 730000, China
^2.Intensive Care Unit, Donggang Branch of The First Hospital of Lanzhou University, Lanzhou 730000, China
^3.Intensive Care Unit, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China

Received:2025-11-07 Accepted:2026-03-09 Online:2026-05-15 Published:2026-05-15
Contact: Yuan Yuan, E-mail: 695203897@qq.com.
Supported by:
University Teacher Innovation Fund of Gansu Province(2023B-002);Graduate Innovation and Entrepreneurship Project of Gansu University of Chinese Medicine(2026CXCY-116);Intra-Hospital Fund of The First Hospital of Lanzhou University(ldyyyn2021-52)

摘要/Abstract

摘要：

中枢神经系统感染是神经外科手术后的常见并发症，致病菌以细菌为主，真菌感染少见。该文报告1例外伤后脑出血行开颅手术患者的诊疗经过。患者术后1个月出现不明原因发热、嗜睡，伴颈强直，临床高度怀疑为中枢神经系统感染，但传统脑脊液常规及生化检查结果缺乏特异性，且脑脊液培养呈阴性，遂行脑脊液宏基因组二代测序（metagenomic next-generation sequencing，mNGS）。mNGS结果检测到库德里阿兹威毕赤酵母菌［Pichia kudriavzevii；临床通用名称为克柔念珠菌（Candida krusei）］。结合患者临床表现、体征及辅助检查结果，诊断为中枢神经系统克柔念珠菌感染。经伏立康唑抗真菌治疗4周余，患者病情好转出院，定期随访未见复发。该病例提示，对于临床表现及常规检查不典型的中枢神经系统感染，mNGS可快速、准确识别罕见病原体，为早期目标性治疗提供关键依据，有助于改善患者预后。

关键词: 中枢神经系统感染, 克柔念珠菌, 库德里阿兹威毕赤酵母菌, 宏基因组二代测序

Abstract:

Central nervous system (CNS) infections are common complications following neurosurgery, with bacteria being the predominant pathogens, while fungal infections are rare. This article reports the diagnosis and treatment of a patient with traumatic intracerebral hemorrhage who underwent craniotomy. One month after surgery, the patient developed unexplained fever, lethargy, and neck stiffness, raising a high clinical suspicion of CNS infection. However, conventional cerebrospinal fluid (CSF) routine and biochemical tests lacked specificity, and CSF culture was negative. Consequently, metagenomic next-generation sequencing (mNGS) of the CSF was performed. The mNGS results identified Pichia kudriavzevii (clinically known as Candida krusei). Based on the patient's clinical manifestations, signs, and auxiliary examination findings, a diagnosis of CNSinfection caused by Candida krusei was made. After more than 4 weeks of antifungal therapy with voriconazole, the patient′s condition improved and the patient was discharged. No recurrence was observed during follow-up. This case suggests that for CNS infections with atypical clinical presentations and nonspecific routine laboratory findings, mNGS can rapidly and accurately identify rare pathogens, providing a key basis for early targeted therapy and contributing to improved patient outcomes.

Key words: central nervous system infection, Candida krusei, Pichia kudriavzevii, metagenomic next-generation sequencing (mNGS)

中图分类号:

R446.5

邓园园, 袁媛. 克柔念珠菌致中枢神经系统感染个案报告[J]. 上海交通大学学报（医学版）, 2026, 46(5): 688-692.

Deng Yuanyuan, Yuan Yuan. Case report of central nervous system infection caused by Candida krusei[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(5): 688-692.

图/表 1

参考文献 26

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Item	2024-12-06	2024-12-12	2024-12-29	2025-01-15
Routine examination
Color	Pale yellow	Pale yellow	Colorless	Colorless
Clarity	Clear	Clear	Clear	Clear
Coagulability	No clots	No clots	No clots	No clots
Protein (Qualitative)	Positive	Negative	Negative	Negative
RBC count/(×10⁶/L)	1	52	80	0
WBC count/(×10⁶/L)	9	13	17	3
Biochemical examination
Total protein/(mg·dL^-1)	105(↑)	46(↑)	38	31
Chloride/(mmol·L^-1)	117(↓)	115(↓)	124	126
Glucose/(mmol·L^-1)	3.29	3.03	3.14	3.70
LDH/(U·L^-1)	58(↑)	33	24	18
ADA/(U·L^-1)	0.2	0.6	0.4	2.0
Pressure/mmH₂O	250(↑)	200(↑)	50	60

Item	2024-12-06	2024-12-12	2024-12-29	2025-01-15
Routine examination
Color	Pale yellow	Pale yellow	Colorless	Colorless
Clarity	Clear	Clear	Clear	Clear
Coagulability	No clots	No clots	No clots	No clots
Protein (Qualitative)	Positive	Negative	Negative	Negative
RBC count/(×10⁶/L)	1	52	80	0
WBC count/(×10⁶/L)	9	13	17	3
Biochemical examination
Total protein/(mg·dL^-1)	105(↑)	46(↑)	38	31
Chloride/(mmol·L^-1)	117(↓)	115(↓)	124	126
Glucose/(mmol·L^-1)	3.29	3.03	3.14	3.70
LDH/(U·L^-1)	58(↑)	33	24	18
ADA/(U·L^-1)	0.2	0.6	0.4	2.0
Pressure/mmH₂O	250(↑)	200(↑)	50	60

克柔念珠菌致中枢神经系统感染个案报告

Case report of central nervous system infection caused by Candida krusei

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