Shelton M M, Marks W A
Infectious Disease Division, Cook-Fort Worth Children's Medical Center, Texas.
Neurol Clin. 1990 Aug;8(3):605-17.
Antibiotics and improvements in supportive care have greatly reduced the mortality from bacterial meningitis. Nevertheless, the incidence of neurodevelopmental sequelae remains unacceptably high. Ampicillin and chloramphenicol remain the standard for antimicrobial therapy against which other agents must be compared. A number of adjunct therapies are being investigated for their possible effectiveness in reducing hearing loss and other neurologic effects of this disease. There continues to be a need for carefully performed follow-up studies to assess any possible benefit of these agents. A significant percentage of children surviving an episode of bacterial meningitis have obvious or subtle neurodevelopmental deficits. The role of the pediatric neurologist should not end with management of acute problems such as seizures but should be expanded to aid in close developmental monitoring of these high-risk children.
抗生素及支持治疗的改善已大幅降低了细菌性脑膜炎的死亡率。然而，神经发育后遗症的发生率仍然高得令人难以接受。氨苄西林和氯霉素仍是抗菌治疗的标准药物，其他药物必须与之进行比较。目前正在研究多种辅助治疗方法，以评估其在降低该疾病听力损失和其他神经学影响方面的潜在效果。仍需要进行精心实施的随访研究，以评估这些治疗方法的任何潜在益处。相当比例的细菌性脑膜炎发作后存活的儿童存在明显或细微的神经发育缺陷。儿科神经科医生的作用不应仅限于处理癫痫等急性问题，而应扩大到协助对这些高危儿童进行密切的发育监测。
