Departments of Neurology Medical Microbiology the Netherlands.
Clin Microbiol Infect. 2012 Apr;18(4):345-51. doi: 10.1111/j.1469-0691.2011.03465.x. Epub 2011 Mar 7.
Few cases of bacterial meningitis during pregnancy have been reported in the literature, and the causative microorganisms and prognosis of bacterial meningitis during pregnancy are unclear. In a 6-year period we identified six cases of bacterial meningitis in pregnant women. All were multigravida and gestational age at presentation ranged from 5 to 39 weeks. Predisposing factors were present in five patients and consisted of otitis in four patients. The causative organism was Streptococcus pneumoniae in all patients. Two patients died, both due to florid septic shock and brain herniation. Foetal outcome was good in five cases; one woman had a miscarriage 3 weeks after the episode of bacterial meningitis. We reviewed the literature on bacterial meningitis during pregnancy and identified 42 cases of bacterial meningitis. Twenty-five of these patients had pneumococcal meningitis and seven had meningitis caused by L. monocytogenes. We found that pneumococcal meningitis during pregnancy can be rapidly fatal and is associated with foetal death, especially in the first trimester. L. monocytogenes meningitis was associated with a high rate of neonatal deaths.
在文献中很少有报道怀孕期间发生细菌性脑膜炎的病例，且怀孕期间细菌性脑膜炎的致病微生物和预后尚不清楚。在 6 年期间，我们在 6 例孕妇中发现了细菌性脑膜炎。所有患者均为多产妇，就诊时的孕周为 5 至 39 周。5 例患者存在诱发因素，包括 4 例中耳炎。所有患者的病原体均为肺炎链球菌。2 例患者死亡，均死于严重败血症性休克和脑疝。5 例患者的胎儿结局良好；1 例患者在细菌性脑膜炎发作后 3 周发生流产。我们回顾了有关怀孕期间细菌性脑膜炎的文献，共确定了 42 例细菌性脑膜炎病例。其中 25 例患者为肺炎球菌性脑膜炎，7 例为单核细胞增生李斯特菌性脑膜炎。我们发现，怀孕期间的肺炎球菌性脑膜炎可能迅速致命，并伴有胎儿死亡，尤其是在妊娠早期。单核细胞增生李斯特菌性脑膜炎与新生儿死亡发生率高有关。
