【摘要】 以免疫功能正常的青年男性颅内黄曲霉感染病例，探讨其临床特点及诊断治疗经验。回顾性分析1例以高热、头痛起病，后进展为脑膜炎患者的临床资料，结合脑脊液宏基因二代测序（mNGS）结果及治疗转归进行总结。患者急性起病，初期经验性抗感染无效，逐渐出现意识障碍及脑膜刺激征；脑脊液检查提示炎性改变，常规病原学检测阴性，mNGS检出黄曲霉特异性序列（27条）。经伏立康唑抗真菌治疗后症状显著改善，随访3个月无复发。对于不明原因中枢神经系统感染，尤其是常规检测阴性者，mNGS可提高罕见病原体（如黄曲霉）的检出率，早期诊断及针对性抗真菌治疗是改善预后的关键。即使无免疫功能异常，亦需警惕侵袭性真菌感染的可能。更多还原

【Abstract】 To report a case of an immunocompetent young adult male patient diagnosed with intracranial Aspergillus flavus infection, and to investigate the clinical features of this disease and related experience in diagnosis and treatment. A retrospective analysis was performed for the clinical data of a patient who had the initial presentation of high fever and headache and then progressed to meningoencephalitis, and the results of cerebrospinal fluid(CSF) metagenomic nextgeneration sequencing(mNGS) and treatment outcomes were summarized. The patient had an acute onset, with no response to empirical anti-infective therapy in the incipient stage, and then he gradually developed disturbance of consciousness and meningeal irritation sign. CSF analysis showed inflammatory changes, while conventional pathogen tests yielded negative results, and mNGS detected 27 specific sequences of Aspergillus flavus. The symptoms of the patient was significantly improved after antifungal therapy with voriconazole, with no recurrence after follow-up for 3 months. For unexplained central nervous system infections, especially those with negative results from conventional tests, mNGS can improve the detection rate of rare pathogens(e.g.,Aspergillus flavus). Early diagnosis and targeted antifungal therapy are crucial for improving prognosis. This case highlights that invasive fungal infections should be considered even in immunocompetent individuals.更多还原