Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.
J Pediatr Surg. 2012 Dec;47(12):2336-40. doi: 10.1016/j.jpedsurg.2012.09.029.
Cephalhematoma is normally a self-limiting condition affecting 1%-2% of live births, especially following instrumental forceps delivery. The sub-periosteal bleed is characteristically limited by the cranial sutures. Although benign in most instances, this condition may, in a small proportion of cases, be complicated by hyperbilirubinemia or scalp infection. We describe a case of cephalhematoma in a newborn infant infected with Escherichia coli resulting in an extensive deep seated scalp abscess. The infection was also systemic causing E. coli septicemia and initial assessment assumed local extension including bone and meningeal to cause skull osteomyelitis and meningitis respectively. Further investigations and multiple-modality imaging with ultrasound, CT scan and bone scintigraphy outlined the involvement as limited to the scalp, resulting in a shorter antibiotic treatment period and earlier discharge from hospital. The infant recovered well with parenteral antibiotics, saucerization of the abscess and a later skin grafting procedure.
头颅血肿通常是一种自限性疾病，影响 1%-2%的活产儿，特别是在使用产钳助产之后。骨膜下出血的特征是受颅骨缝限制。尽管在大多数情况下是良性的，但这种情况在一小部分病例中可能会因高胆红素血症或头皮感染而变得复杂。我们描述了一例由大肠杆菌感染引起的新生儿头颅血肿，导致广泛的深部头皮脓肿。感染也是全身性的，导致大肠杆菌败血症，最初的评估假设局部扩展包括骨和脑膜，分别导致颅骨骨髓炎和脑膜炎。进一步的调查和多模式成像，包括超声、CT 扫描和骨闪烁扫描，表明病变仅限于头皮，这导致抗生素治疗时间缩短，更早出院。婴儿通过静脉注射抗生素、脓肿切开引流术和后期植皮术恢复良好。
