【摘要】 患者女，51岁，因低热3个半月，肢体麻木、无力2个月入院。影像检查提示中枢神经系统多发病灶；脑脊液宏基因组二代测序（mNGS）提示巨细胞病毒感染；痰液及肺泡灌洗液检查提示结核分枝杆菌、耶氏肺孢子菌、肺炎链球菌等多重感染；纵隔占位活检组织病理检查，初步诊断A型胸腺瘤；行淋巴细胞亚群检查提示血清免疫球蛋白IgG及IgM减少，总B淋巴细胞、辅助性T细胞、抑制性T细胞以及CD4~+/CD8~+比值均显著下降，确诊为Good综合征（GS）。该患者经静脉滴注人免疫球蛋白治疗后，肢体无力症状平稳好转，肺部感染得到控制出院。更多还原

【Abstract】 One 51-year-old female patient was admitted to the hospital with a low-grade fever for 3.5 months and limb numbness and weakness for 2 months. Imaging showed multiple lesions in the central nervous system. The macrogenomic second-generation sequencing(mNGS)of cerebrospinal fluid indicated cytomegalovirus infection. The sputum and bronchoalveolar lavage fluid showed multiple infections of Mycobacterium tuberculosis, Pneumocystis jasinii and Streptococcus pneumoniae. A histopathological examination of mediastinal space biopsy was performed, and a preliminary diagnosis of type A thymoma was made; lymphocyte subpopulation examination revealed a serum immunoglobulin IgG and IgM decreased, B lymphocytes, helper T cell, suppressor T cell and CD4~+/CD8~+ ratio decreased significantly, which was diagnosed as Good syndrome(GS). After treatment with intravenous immunoglobulin, the patient was discharged with smooth improvement of limb weakness and control of pulmonary infection.更多还原