纯母乳喂养婴儿的巴拿马肠炎沙门氏菌脑膜炎：4例报告、临床特征及治疗挑战
Salmonella enterica serovar Panama meningitis in exclusive breastfeeding infants: Report of 4 cases, clinical features and therapeutic challenges.
作者信息
Elenga Narcisse, Cuadro Emma, Long Laurence, Njuieyon Falucar, Martin Elise, Kom-Tchameni Rémi, Defo Antoine, Razafindrakoto Sitraka H, Mrsic Yajaira, Henaff Fanny, Mahamat Aba
机构信息
Department of Pediatrics Deparment of Infectious Diseases, Cayenne Regional Hospital, Rue des Flamboyants, BP 6006, 97306 Cayenne Cedex, French Guiana, France.
出版信息
Medicine (Baltimore). 2017 May;96(19):e6665. doi: 10.1097/MD.0000000000006665.
RATIONALE
The pathway of Nontyphoid Salmonella meningitis, especially in exclusive breastfeeding infants, has not been well characterized.
PATIENT CONCERNS
We analyzed data related to nontyphoid Salmonella meningitis in 4 infants.
DIAGNOSES
No diarrhea was observed and the coproculture was negative for all patients.
INTERVENTIONS
Early diagnosis and treatment with combination of third-generation cephalosporins plus quinolones for a minimum of 3 weeks is necessary to avoid severe sequelae and death.
OUTCOMES
The first 3 patients had a good evolution, whereas the last patient had multiple brain abscesses and hydrocephalus requiring treatment with a ventriculoperitoneal shunt.
LESSONS
The highlights of our study are that all infants were exclusively breastfed, no diarrhea observed and the negative coproculture for all the 4 patients, which is relatively rare for Salmonella infection.
原理
非伤寒沙门氏菌性脑膜炎的发病途径，尤其是在纯母乳喂养婴儿中，尚未得到充分阐明。
患者情况
我们分析了4例婴儿非伤寒沙门氏菌性脑膜炎的相关数据。
诊断
所有患者均未观察到腹泻，粪便培养均为阴性。
干预措施
早期诊断并联合使用第三代头孢菌素加喹诺酮类药物治疗至少3周，以避免严重后遗症和死亡。
结果
前3例患者病情进展良好，而最后1例患者出现多发性脑脓肿和脑积水，需要进行脑室腹腔分流术治疗。
经验教训
我们研究的重点是所有婴儿均为纯母乳喂养，未观察到腹泻，且4例患者粪便培养均为阴性，这在沙门氏菌感染中相对少见。
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