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小儿细菌性脑膜炎:早期识别与管理的最新进展

Pediatric bacterial meningitis: an update on early identification and management.

作者信息

Posadas Emerson, Fisher Jay

机构信息

Department of Emergency Medicine, University of Nevada, Las Vegas School of Medicine, Las Vegas, NV.

Clinical Professor of Emergency Medicine and Pediatrics, University of Nevada, Las Vegas School of Medicine; Medical Director, Pediatric Emergency Services, Children's Hospital of Nevada at University Medical Center, Las Vegas, NV.

出版信息

Pediatr Emerg Med Pract. 2018 Nov;15(11):1-20. Epub 2018 Nov 1.

Abstract

The presentation of bacterial meningitis can overlap with viral meningitis and other conditions, and emergency clinicians must remain vigilant to avoid delaying treatment for a child with bacterial meningitis. Inflammatory markers, such as procalcitonin, in the serum and cerebrospinal fluid may help distinguish between bacterial meningitis and viral meningitis. Appropriate early antibiotic treatment and management for bacterial meningitis is critical for optimal outcomes. Although debated, corticosteroids should be considered in certain cases. This issue provides evidence-based recommendations for the early identification and appropriate management of bacterial meningitis in pediatric patients.

摘要

细菌性脑膜炎的临床表现可能与病毒性脑膜炎及其他病症重叠,急诊临床医生必须保持警惕,以免延误对细菌性脑膜炎患儿的治疗。血清和脑脊液中的炎症标志物,如降钙素原,可能有助于区分细菌性脑膜炎和病毒性脑膜炎。对细菌性脑膜炎进行适当的早期抗生素治疗和管理对于获得最佳治疗效果至关重要。尽管存在争议,但在某些情况下应考虑使用皮质类固醇。本期为儿科患者细菌性脑膜炎的早期识别和适当管理提供了循证建议。

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