Karunakaran Rina, Marret Mary J, Hassan Hamimah, Puthucheary Savithri D
Department of Medical Microbiology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.
Malays J Pathol. 2004 Jun;26(1):49-52.
A 2-year-old boy with underlying congenital cyanotic heart disease presented with seizures and fever and was found to have bilateral parietal cerebral abscesses. Drainage of the pus from the abscesses was done in stages; on the day of admission, four days after admission and 3 weeks after admission. Although the pus from the first drainage did not grow any organisms, the pus from the second drainage on the fourth day of admission yielded a mixed growth of Eikenella corrodens and Streptococcus milleri. Following the second drainage of pus, the child was noted to have mild weakness (grade 3/5) and increased tone in the left upper limb. Three weeks after admission, due to recurring fever, further neurological signs and findings of an enlarging right cerebral abscess on a repeat CT scan, a third drainage was carried out. However no growth was obtained from this specimen. This patient was managed both surgically and with appropriate antibiotics. Over the next four months, serial CT scans revealed gradual resolution of the abscesses with disappearance of the surrounding oedema. The child showed gradual recovery of his left sided weakness with resolution of tone and reflexes to normal.
一名患有先天性青紫型心脏病的2岁男孩出现癫痫发作和发热症状,经检查发现双侧顶叶脑脓肿。脓肿的脓液分阶段进行引流,分别在入院当天、入院后4天和入院后3周进行。虽然首次引流的脓液未培养出任何微生物,但入院第4天第二次引流的脓液培养出了腐蚀艾肯菌和米勒链球菌的混合菌群。第二次引流脓液后,发现患儿左上肢轻度无力(3/5级)且肌张力增加。入院3周后,由于反复发热、出现进一步的神经体征以及复查CT扫描发现右侧脑脓肿增大,进行了第三次引流。然而,此次引流标本未培养出任何微生物。该患者接受了手术治疗并使用了适当的抗生素。在接下来的四个月里,系列CT扫描显示脓肿逐渐消退,周围水肿消失。患儿左侧肢体无力逐渐恢复,肌张力和反射恢复正常。