Lin Hung-Wei, Yin Jiu-Haw, Lo Jenn-Pyng, Wang Yi-Hui, Lee Shih-Yi, Lu Jang-Jih
Department of Medicine, Armed Forces Tao-Yuan General Hospital, Taipei, Taiwan, ROC.
J Microbiol Immunol Infect. 2004 Dec;37(6):371-4.
Neisseria meningitidis is a major cause of bacterial meningitis worldwide, especially in children. Early diagnosis and empiric antibiotic treatment have led to a reduction in morbidity and mortality. The value of the traditional gold standard diagnostic tests, blood culture and cerebrospinal fluid (CSF) culture, has been adversely affected by preadmission use of parenteral penicillin and fewer lumbar punctures. We report a case of N. meningitidis in a 19-year-old male who was admitted after suffering from progressive severe headache, and intermittent high fever for 2 days. Gram stain and culture of CSF, and culture of throat swab were negative. However, N. meningitidis was detected by polymerase chain reaction (PCR) with a universal primer set and endonuclease digestion. This report indicated that the PCR method may be an alternative method for the rapid diagnosis of meningococcal meningitis.
脑膜炎奈瑟菌是全球细菌性脑膜炎的主要病因，尤其是在儿童中。早期诊断和经验性抗生素治疗已使发病率和死亡率有所降低。传统金标准诊断试验（血培养和脑脊液培养）的价值受到入院前胃肠外使用青霉素以及腰椎穿刺减少的不利影响。我们报告一例19岁男性脑膜炎奈瑟菌感染病例，该患者因进行性严重头痛和间歇性高热2天后入院。脑脊液革兰氏染色和培养以及咽拭子培养均为阴性。然而，使用通用引物组和核酸内切酶消化的聚合酶链反应（PCR）检测到了脑膜炎奈瑟菌。本报告表明，PCR方法可能是快速诊断脑膜炎球菌性脑膜炎的一种替代方法。
