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婴儿肺炎球菌性脑膜炎和心内膜炎:可能因存在因子 V Leiden 突变而改善生存。

Pneumococcal meningitis and endocarditis in an infant: possible improved survival with factor V Leiden mutation.

机构信息

Paediatric Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds, LS1 3EX, UK.

Paediatric Cardiology, Leeds Teaching Hospitals, Leeds, LS1 3EX, UK.

出版信息

Eur J Pediatr. 2017 Oct;176(10):1439-1442. doi: 10.1007/s00431-017-2973-1. Epub 2017 Aug 12.

Abstract

UNLABELLED

Streptococcus pneumoniae infections continue to remain associated with high morbidity and mortality. Although the incidence of invasive meningeal and/or lung disease are not uncommon, Streptococcus pneumoniae endocarditis is rare especially in healthy pediatric population. New studies have suggested a strong association between factor V leiden (FVL) mutation and favorable outcomes in critically ill children. A healthy 10 month old presented with sepsis and meningeal signs, was later confirmed to have Streptococcus pneumoniae meningitis and endocarditis. She was found to have factor V leiden mutation and made a complete recovery despite initial complications.

CONCLUSION

Presence of factor V leiden mutation in critically ill children with severe septicaemia possibly contributes to better outcomes. What is known: • Mortality and morbidity remain high with invasive pneumococcal disease. • Pneumococcal endocarditis is rare in healthy pediatric population and results in significant morbidity and mortality What is new: • New studies have suggested a strong association between factor V leiden (FVL) mutation and favorable outcomes in critically ill children. • The presence of factor V mutation in children with extensive invasive pneumococcal disease possibly contributes to a better outcome.

摘要

背景

肺炎链球菌感染仍然与高发病率和死亡率相关。虽然侵袭性脑膜和/或肺部疾病的发病率并不罕见,但肺炎链球菌性心内膜炎在健康的儿科人群中很少见。新的研究表明,因子 V 莱顿(FVL)突变与危重症儿童的良好结局之间存在很强的关联。

病例报告

一名 10 个月大的健康婴儿出现败血症和脑膜体征,后来被确诊为肺炎链球菌性脑膜炎和心内膜炎。她被发现存在因子 V 莱顿突变,但尽管最初出现并发症,她还是完全康复了。

结论

危重症严重败血症儿童中存在因子 V 莱顿突变可能有助于改善结局。已知情况:•侵袭性肺炎球菌病的死亡率和发病率仍然很高。•健康儿科人群中肺炎链球菌性心内膜炎罕见,但会导致严重的发病率和死亡率。新情况:•新的研究表明,因子 V 莱顿(FVL)突变与危重症儿童的良好结局之间存在很强的关联。•广泛侵袭性肺炎球菌病患儿存在因子 V 突变可能有助于改善结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f59/5602074/2452783abcf5/431_2017_2973_Fig1_HTML.jpg

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