Salehian Sormeh, Rastogi Abhinav, Ghez Olivier, Burmester Margarita
Paediatric Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
Imperial College London, London, UK Royal Brompton and Harefield NHS Foundation Trust, London, UK.
BMJ Case Rep. 2016 Sep 27;2016:bcr2015214326. doi: 10.1136/bcr-2015-214326.
Group B streptococcus (GBS) is recognised as one of the leading organisms in early-onset neonatal sepsis but is also a cause of late-onset GBS septicaemia, meningitis and rarely, infective endocarditis (IE). We report a case of a healthy term neonate who developed GBS septicaemia and meningitis having presented with parental concern and poor feeding. Subsequent identification and treatment of GBS resulted in the requirement for long-line intravascular access in order to administer antibiotic therapy. One week later, after repeated parental concern and symptoms of shortness of breath, the neonate presented to Accident and Emergency and subsequently a Paediatric Cardiorespiratory Intensive Care Unit where emergency resuscitation procedures were required and diagnosis of severe IE affecting the mitral valve was made. Mitral valve replacement was complicated with significant morbidity and prolonged hospitalisation. An innovative procedure to insert a Melody valve was successful.
B族链球菌（GBS）被认为是早发型新生儿败血症的主要病原体之一，但也是晚发型GBS败血症、脑膜炎的病因，感染性心内膜炎（IE）则较为罕见。我们报告了一例足月健康新生儿病例，该患儿因家长担心和喂养困难就诊，随后被诊断为GBS败血症和脑膜炎。对GBS的后续鉴定和治疗需要进行长期血管内通路置管以便给予抗生素治疗。一周后，经家长反复担心及患儿出现呼吸急促症状，该新生儿被送往急诊，随后转入儿科心肺重症监护病房，在那里需要进行紧急复苏程序，并诊断出严重的二尖瓣IE。二尖瓣置换术出现了严重并发症并导致住院时间延长。成功实施了一项插入美敦力瓣膜的创新手术。
