Department of Pediatrics, Bethune International Peace Hospital Shijiazhuang, Province of Hebei, China.
Minerva Med. 2013 Jun;104(3):349-55.
This study examined clinical features and neuroimaging characteristics of severe brain damage in premature infants with postnatal infection.
We retrospectively analyzed clinical data of two preterm infants who developed extensive encephalomalacia secondary to postnatal infection.
Two premature boys experienced serious postnatal infection at about 3 weeks after birth; the infection was characterized by lethargy, apnea, increased CRP, severe bilateral pneumonia, positive sputum culture for multidrug-resistant bacteria, and mild changes of cerebrospinal fluid. Both infants required ventilation and antibiotic therapy. While both infants survived, a very extensive encephalomalacia was documented by serial cranial ultrasound, MRI and CT scans 3 to 4 weeks after postnatal infection. Their mothers had no premature ruptures of membranes and no signs of antenatal infection, suggesting potential postnatal infection in the infants.
More studies are needed to better understand the underlying mechanism of encephalomalacia associated with postnatal infection. To facilitate early diagnosis and effective treatment, cranial ultrasound scans should be done routinely in premature infants with serious postnatal infection.
本研究旨在探讨感染后脑损伤早产儿的临床特征和神经影像学特征。
我们回顾性分析了 2 例因产后感染而发生广泛脑软化的早产儿的临床资料。
2 名早产男婴均在出生后 3 周左右发生严重的产后感染；感染表现为嗜睡、呼吸暂停、CRP 升高、严重双侧肺炎、痰培养多重耐药菌阳性、脑脊液轻度改变。均需呼吸机辅助通气和抗生素治疗。虽然两名患儿均存活，但在感染后 3 至 4 周的连续头颅超声、MRI 和 CT 扫描显示，均存在非常广泛的脑软化。患儿母亲均无胎膜早破且无产前感染迹象，提示可能存在产后感染。
需要更多的研究来更好地理解与产后感染相关的脑软化的潜在机制。为了便于早期诊断和有效治疗，对于严重的产后感染早产儿，应常规进行头颅超声检查。
