Nimir Amal Rashad, Ibrahim Rosni, Ibrahim Ibrahim Abdel Aziz
Cyberjaya University College of Medical Sciences, Cyberjaya, Malaysia.
BMJ Case Rep. 2011 Jul 20;2011:bcr0420114096. doi: 10.1136/bcr.04.2011.4096.
The authors report a case of a 6-week-old baby girl who was admitted to the paediatric ward due to a high fever for 2 days. The patient experienced three fits which took place while in the ward. A brain sonogram showed subdural heterogeneous collection consistent with focal empyema; however, no hydrocephalus or infarction was detected. An urgent Burr hole procedure was performed to remove the collected pus. Both blood and cerebrospinal fluid (CSF) culture grew Salmonella species which remain sensitive to some antibiotics. This strain was sent to the institute of medical research (IMR) for serotyping. The patient was treated with intravenous combination of ceftriaxone and ciprofloxacin for 3 weeks. One week later, IMR sent results that identified the strain as Salmonella enterica serotype Houtenae. Following antibiotic treatment, repeat ultrasound illustrated an improvement of the subdural empyema, and the gram stain of the CSF specimen failed to isolate bacteria.
作者报告了一例6周大的女婴病例，该女婴因持续2天的高烧被收治入儿科病房。患者在病房期间发生了三次惊厥。脑部超声显示硬膜下有不均匀的积液，符合局灶性积脓；然而，未检测到脑积水或梗死。紧急进行了钻孔手术以清除积聚的脓液。血液和脑脊液（CSF）培养均培养出沙门氏菌属，该菌对某些抗生素仍敏感。该菌株被送往医学研究所（IMR）进行血清分型。患者接受了头孢曲松和环丙沙星静脉联合治疗3周。一周后，IMR发来结果，确定该菌株为肠炎沙门氏菌霍特内亚种。抗生素治疗后，重复超声显示硬膜下积脓有所改善，脑脊液标本的革兰氏染色未分离出细菌。
