Scharek Petra, Jekkel Csilla, Budai József, Szilasi Zsuzsanna, Helferich Frigyes, Arva Ilona, Váradi András, Létay Erzsébet, Katona Katalin, Rókusz László
Ideggyogy Sz. 2014 Jan 30;67(1-2):56-8.
Bacterial meningitis is a life-threatening disease. The incidence of meningitis is about 2.6-6 cases per 100.000 adults per year in developed countries. The most common causative microorganisms are Sreptococcus pneumoniae and Neisseria meningitidis. A 33-year-old multigravida, at 24 week of gestation was admitted to the hospital because of ear pain, haedache, fever and confusion. Lumbal puncture was performed and cerebrospinal fluid analysis showed signs of bacterial meningitis. Latex agglutination test was positive for S. pneumoniae, Gram-positive diplococci have seen under microscope and later cultivation verified S. pneumoniae as the causative agent. After ceftriaxon, dexamethasone administration and treatment in intensive care unit, left side mastoidectomy was performed since cranial computed tomography showed acut exacerbation of chronic mastoiditis on the left side. After extubation, mobilisation and 14 days antibiotic treatment the patient, who had residual hearing loss on the left side, was discharged from the hospital. During the treatment the foetal parameters were normal. The patient at 39 week of gestation gave birth to a healthy infant. Forty-eight case reports have been published in this topic around the world until April, 2012. The most common causative agents were S. pneumoniae and Listeria monocytogenes. Because of the little amount of data, it is hard to appreciate the actual incidence and prognosis of this life-threatening illness both for mother and infant. As far as we know this is the first published case report of meningitis during pregnancy in Hungary. By this article we would like to draw attention to the importance of teamwork, of prevention of brain abscess formation and of the removal of the infection's focus.
细菌性脑膜炎是一种危及生命的疾病。在发达国家，脑膜炎的发病率约为每年每10万成年人中有2.6 - 6例。最常见的致病微生物是肺炎链球菌和脑膜炎奈瑟菌。一名33岁的经产妇，妊娠24周时因耳痛、头痛、发热和意识模糊入院。进行了腰椎穿刺，脑脊液分析显示有细菌性脑膜炎的迹象。乳胶凝集试验显示肺炎链球菌呈阳性，显微镜下可见革兰氏阳性双球菌，随后的培养证实肺炎链球菌为病原体。在给予头孢曲松、地塞米松并在重症监护病房治疗后，由于头颅计算机断层扫描显示左侧慢性乳突炎急性加重，进行了左侧乳突切除术。拔管、活动及14天抗生素治疗后，左侧有残余听力损失的患者出院。治疗期间胎儿参数正常。该患者在妊娠39周时生下一名健康婴儿。截至2012年4月，全球已发表了48篇关于该主题的病例报告。最常见的病原体是肺炎链球菌和单核细胞增生李斯特菌。由于数据量少，很难了解这种危及生命的疾病对母亲和婴儿的实际发病率和预后。据我们所知，这是匈牙利首次发表的妊娠期脑膜炎病例报告。通过本文，我们希望引起人们对团队合作、预防脑脓肿形成以及消除感染源的重要性的关注。
