Department of Pediatrics, Konan Kosei Hospital, 137 Ohmatsubara, Takaya-cho, Konan, Aichi 483-8704, Japan.
J Infect Chemother. 2009 Oct;15(5):322-4. doi: 10.1007/s10156-009-0704-x. Epub 2009 Oct 24.
We report a previously healthy 14-month-old boy who developed community-acquired Acinetobacter baumannii meningitis. He had no history of immunodeficiency, and was brought to Konan Kosei Hospital with a high fever and vomiting. His consciousness was clear, but neck stiffness was noted. Examination of the cerebrospinal fluid (CSF) revealed a cell count of 10 112/microl; protein, 216 mg/dl; and glucose, 9 mg/dl. A CSF test kit for bacterial capsular antigens (Pastorex Meningitis; Bio-Rad Laboratories) was positive for Haemophilus influenzae type b antigen. On day 3 of admission, the microorganism isolated by CSF culture was identified as A. baumannii. Therefore, his treatment was changed to meropenem hydrate from the initial therapy with panipenem/betamipron and ceftriaxone sodium hydrate. Because the CSF cell count remained elevated, meropenem hydrate was administered for a total of 19 days. The meningitis resolved with no sequelae.
我们报告一例先前健康的 14 月龄男童，患社区获得性鲍曼不动杆菌脑膜炎。患儿无免疫缺陷病史，因高热和呕吐至冈南圣心医院就诊。其意识清楚，但存在颈项强直。脑脊液（CSF）检查示细胞数 10112/μl，蛋白 216mg/dl，葡萄糖 9mg/dl。细菌荚膜抗原 CSF 检测试剂盒（Pastorex Meningitis；Bio-Rad Laboratories）对乙型流感嗜血杆菌抗原检测阳性。入院第 3 天，CSF 培养分离出的微生物鉴定为鲍曼不动杆菌。因此，初始治疗方案中的帕尼培南/倍他米隆和头孢曲松钠被美罗培南一水合物取代。由于 CSF 细胞计数持续升高，美罗培南一水合物共使用 19 天。脑膜炎痊愈，无后遗症。
