Cantey Joseph B, Tamma Pranita
Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA.
Pediatr Emerg Care. 2011 Jan;27(1):34-5. doi: 10.1097/PEC.0b013e3182045bfb.
Viridans streptococcal meningitis is a rare occurrence, usually as a result of iatrogenic invasion of the dural space or significant immunosuppression. We report a case of an otherwise healthy child who had Streptococcus salivarius meningitis as a result of lacerations to the posterior neck after a fall onto a drinking glass. Despite being well appearing on initial presentation, our patient had pneumocephalus on head computed tomography that was not initially recognized. He was discharged from the emergency department and subsequently returned within 24 hours with meningismus. This case highlights the increased risk of meningitis in patients with cerebrospinal fluid leak and the importance of radiographic signs that suggest a traumatic fistula may have occurred. To our knowledge, this is the first case of viridians streptococcal meningitis after penetrating trauma to the neck.
草绿色链球菌性脑膜炎较为罕见，通常是医源性硬脑膜腔侵犯或严重免疫抑制的结果。我们报告一例原本健康的儿童病例，该儿童因跌倒在玻璃杯上导致后颈部裂伤，进而感染了唾液链球菌性脑膜炎。尽管最初就诊时患儿情况良好，但我们的患者在头部计算机断层扫描中发现有气颅，最初未被识别。他从急诊科出院，随后在24小时内因颈项强直再次就诊。该病例强调了脑脊液漏患者发生脑膜炎的风险增加，以及提示可能发生创伤性瘘管的影像学征象的重要性。据我们所知，这是首例颈部穿透性创伤后发生草绿色链球菌性脑膜炎的病例。
