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脑膜炎奈瑟菌引起的新生儿败血症和脑膜炎:一例报告

Neonatal sepsis and meningitis caused by Neisseria meningitidis: a case report.

作者信息

Falcão Mário Cícero, Andrade Samantha Brasil de, Ceccon Maria Esther Jurfest Rivero, Costa Vaz Flávio Adolfo

机构信息

Faculdade de Medicina da Universidade de São Paulo, UCINE, SP, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2007 May-Jun;49(3):191-4. doi: 10.1590/s0036-46652007000300010.

Abstract

OBJECTIVE

To report a full-term newborn infant that developed a sepsis associated to meningitis caused by Neisseria meningitidis serogroup C on the 14th day of life.

CASE DESCRIPTION

The patient was a term female infant, born to a mother with Systemic Lupus Erythematosus, with birth weight of 2,610 g, Apgar Score 1, 4 and 8, who needed mechanical ventilation for 24 hours. On the 7th day of life, the neonate was discharged from the hospital with good overall condition. On the 15th day of life, the newborn infant presented fever and respiratory failure. The cerebrospinal fluid showed 1042 cells/mm3, with neutrophilic predominance, protein of 435 mg/dL, and glucose < 10 mg/dL. The blood and the cerebrospinal fluid cultures were positive for Neisseria meningitidis serogroup C. The neonate was hospitalized, needing mechanical ventilation and vasoactive drugs, and received 21 days of crystalline penicillin. After hospital discharge, there were no signs of neurological sequels and the infant was able to be breastfed. The case report presents a unique situation: an uncommon etiology of neonatal meningitis and favorable evolution, despite neurological sequels reported in the literature. This report emphasizes the need to prevent the premature exposure of newborn infants to pathological agents, especially if they presented birth injuries and/or are preterm, due to their lack of immunological capacity.

摘要

目的

报告一例足月新生儿,在出生第14天发生了由C群脑膜炎奈瑟菌引起的与脑膜炎相关的败血症。

病例描述

该患者为足月女婴,母亲患有系统性红斑狼疮,出生体重2610克,阿氏评分分别为1分、4分和8分,需要机械通气24小时。出生后第7天,新生儿状况良好出院。出生后第15天,新生儿出现发热和呼吸衰竭。脑脊液显示每立方毫米有1042个细胞,以中性粒细胞为主,蛋白质为435毫克/分升,葡萄糖<10毫克/分升。血液和脑脊液培养均为C群脑膜炎奈瑟菌阳性。新生儿住院治疗,需要机械通气和血管活性药物,并接受了21天的结晶青霉素治疗。出院后,没有神经后遗症的迹象,婴儿能够进行母乳喂养。该病例报告呈现了一种独特的情况:新生儿脑膜炎病因罕见,但预后良好,尽管文献报道有神经后遗症。本报告强调需要防止新生儿过早接触病原体,特别是如果他们有出生损伤和/或早产,因为他们缺乏免疫能力。

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