一名早产新生儿因粘质沙雷氏菌引起的脑脓肿。
Cerebral abscess caused by Serratia marcescens in a premature neonate.
作者信息
Hirooka Tatiana Mattos, Fontes Ricardo Braganca de Vasconcellos, Diniz Edna Maria, Pinto Fernando Campos, Matushita Hamilton
机构信息
Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
出版信息
Arq Neuropsiquiatr. 2007 Dec;65(4A):1018-21. doi: 10.1590/s0004-282x2007000600021.
BACKGROUND
Cerebral abscesses are extremely rare in neonates. Serratia marcescens is an unusual cause of sepsis and neurological spread is especially ominous.
PURPOSE
To report the case of a 34-week neonate who developed this rare condition and to discuss diagnostic and therapeutic measures.
CASE REPORT
A 34-week male neonate sequentially developed respiratory distress syndrome, early sepsis and necrotizing enterocolitis; later cultures revealed S. marcescens. After deterioration, a cerebral abscess became evident, which revealed S. marcescens. Clinical improvement ensued after high-dose amikacin and meropenem.
CONCLUSION
Clinical signs are often non-specific. Proper diagnostic measures, neurosurgical consultation and aggressive antibiotic therapy are essential for these high-risk neonates.
背景
脑脓肿在新生儿中极为罕见。粘质沙雷氏菌是败血症的一种不常见病因，其神经扩散尤其凶险。
目的
报告一例患有这种罕见病症的34周龄新生儿病例，并讨论诊断和治疗措施。
病例报告
一名34周龄男婴先后出现呼吸窘迫综合征、早期败血症和坏死性小肠结肠炎；后来的培养显示为粘质沙雷氏菌。病情恶化后，脑脓肿变得明显，培养也显示为粘质沙雷氏菌。大剂量阿米卡星和美罗培南治疗后临床症状改善。
结论
临床症状通常不具有特异性。对于这些高危新生儿，适当的诊断措施、神经外科会诊和积极的抗生素治疗至关重要。
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