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猪咬伤20天后因猪链球菌脑膜炎导致的双侧感音神经性听力障碍

[Bilateral sensorineural hearing impairment due to Streptococcus suis meningitis 20 days after swine bite].

作者信息

Mori Kousuke, Ishii Nobuyuki, Mochizuki Hitoshi, Taniguchi Akitoshi, Shiomi Kazutaka, Nakazato Masamitsu

机构信息

Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki.

出版信息

Rinsho Shinkeigaku. 2013;53(9):732-5. doi: 10.5692/clinicalneurol.53.732.

Abstract

Streptococcus suis (S. suis) is a zoonotic pathogen in pigs, which can be transmitted to humans by close contact. Meningitis is the most common clinical manifestations of S. suis infection and hearing impairment is a frequent complication. The risk of S. suis meningitis is higher in people who work in the swine industry. The patient was a 53-year-old woman working in the swine industry, who developed headache and fever 20 days after a swine bite. She was diagnosed as meningitis and S. suis was detected in the cerebrospinal fluid. We treated her with ceftriaxone, vancomycin, and dexamethasone, and signs of meningeal irritation diminished three days after admission. However, bilateral sensorineural hearing impairment occurred on the ninth day after admission. We added methylprednisolone (500 mg, 2 days) but moderate hearing impairment remained on the left. Antibiotic therapy should be considered for wounds of people involved in the swine industry for preventing S. suis infection.When S. suis meningitis occurs, symptoms of hearing impairment must be monitored carefully.

摘要

猪链球菌是猪的一种人畜共患病原体,可通过密切接触传播给人类。脑膜炎是猪链球菌感染最常见的临床表现,听力障碍是常见的并发症。从事养猪业的人感染猪链球菌脑膜炎的风险更高。该患者是一名53岁从事养猪业的女性,在被猪咬伤20天后出现头痛和发热。她被诊断为脑膜炎,脑脊液中检测到猪链球菌。我们用头孢曲松、万古霉素和地塞米松对她进行治疗,入院三天后脑膜刺激征减轻。然而,入院第九天出现双侧感音神经性听力障碍。我们加用了甲泼尼龙(500mg,2天),但左侧仍遗留中度听力障碍。对于从事养猪业的人的伤口应考虑进行抗生素治疗以预防猪链球菌感染。当发生猪链球菌脑膜炎时,必须仔细监测听力障碍症状。

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