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[脑膜败血黄杆菌所致新生儿脑膜炎的临床观察]

[Clinical observation of neonatal meningitis caused by flavobacterium meningosepticum].

作者信息

Lin C H, Huang F Y

机构信息

Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.

出版信息

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1991 May-Jun;32(3):171-6.

PMID:1776441
Abstract

From January 1981 to December 1988, we collected 11 cases of neonatal meningitis caused by Flavobacterium meningosepticum. The 6 male and 5 female newborns ranged from 3 days to 20 days old. Birth body weight varied from 1100 gm to 3600 gm. Seven cases were premature or small for date. Nosocomial infection was noted in 7 of these 11 cases. Clinically, lethargy and poor activity were the most common symptoms. Cyanosis, fever and convulsion were the next. There were 9 cases showing pleocytosis, increased protein and decreased glucose level in the cerebrospinal fluid examination. The organisms isolated in all 11 cases were susceptible to piperacillin, resistant to ampicillin, aminoglycosides and cephalosporin. Five patients were treated with antibiotics other than piperacillin for 5 to 18 days. Three patients died; hydrocephalus was the cause of death in 2 of them. Two patients were discharged against advice. Among the remaining 6 cases we gave piperacillin for 3 weeks, one case developed hydrocephalus but eventually succumbed to K. pneumoniae sepsis. Out of five surviving cases, 3 developed hydrocephalus (VP shunt performed in two). The other two patients were discharged without neurological deficit. In conclusion, neonatal Flavobacterium meningosepticum meningitis was more frequent in premature or small for date babies, and it usually appeared in nosocomial infection. The prognosis was poor and piperacillin was proved to be the drug of choice.

摘要

1981年1月至1988年12月,我们收集了11例由脑膜炎败血黄杆菌引起的新生儿脑膜炎病例。6名男婴和5名女婴,年龄在3天至20天之间。出生体重从1100克到3600克不等。7例为早产儿或小于胎龄儿。这11例中有7例为医院感染。临床上,嗜睡和活动减少是最常见的症状。其次是发绀、发热和惊厥。9例脑脊液检查显示有细胞数增多、蛋白升高和葡萄糖水平降低。所有11例分离出的菌株对哌拉西林敏感,对氨苄西林、氨基糖苷类和头孢菌素耐药。5例患者接受了除哌拉西林以外的抗生素治疗5至18天。3例患者死亡;其中2例死于脑积水。2例患者不听劝告自行出院。在其余6例中,我们给予哌拉西林治疗3周,1例发生脑积水,但最终死于肺炎克雷伯菌败血症。在5例存活病例中,3例发生脑积水(2例行脑室腹腔分流术)。另外2例患者出院时无神经功能缺损。总之,新生儿脑膜炎败血黄杆菌脑膜炎在早产儿或小于胎龄儿中更为常见,且通常发生在医院感染中。预后较差,哌拉西林被证明是首选药物。

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