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40日龄婴儿因未诊断出的卡他莫拉菌脑膜脑炎导致意外猝死:病例报告及文献综述

Unexpected and Sudden Death Due to Undiagnosed Moraxella catarrhalis Meningoencephalitis in a 40-day-old Infant: Case Report and Literature Review.

作者信息

Ventura Francesco, Barranco Rosario, Buffelli Francesca, Fulcheri Ezio, Bandettini Roberto, Palmieri Antonella

机构信息

From the Department of Forensic and Legal Medicine, University of Genova.

U.O.S.D. of Fetal and Perinatal Pathology, Istituto Giannina Gaslini.

出版信息

Am J Forensic Med Pathol. 2020 Dec;41(4):333-337. doi: 10.1097/PAF.0000000000000588.

Abstract

Acute bacterial meningitis in infants and newborns represents a medical emergency and a significant cause of mortality and morbidity worldwide. Moraxella catarrhalis has been considered a microorganism with low pathogenic potential, and only in exceptional cases has it been found to cause meningitis in infants and immunocompetent people. We will now document an unusual case of an unexpected and sudden death of a 40-day-old infant due to acute meningitis from M. catarrhalis, apparently asymptomatic and subsequently diagnosed by an autopsy. According to our knowledge this is the first case of unexpected infant death due to undiagnosed M. catarrhalis meningitis.The suggested case, as well as for the rarity of such a fatal event, should be considered a caution to pediatrics and neonatologists for M. catarrhalis can cause paucisymptomatic meningoencephalitis in infants which can be potentially fatal.From a forensic point of view, an autopsy accompanied by a multidisciplinary assessment is always necessary in cases of unexpected infant deaths to identify the causes.

摘要

婴儿和新生儿的急性细菌性脑膜炎是一种医疗急症,也是全球范围内死亡率和发病率的重要原因。卡他莫拉菌一直被认为是一种致病潜力较低的微生物,仅在极少数情况下才会在婴儿和免疫功能正常的人群中引发脑膜炎。我们现将记录一例不同寻常的病例,一名40天大的婴儿因卡他莫拉菌引起的急性脑膜炎意外猝死,该婴儿此前显然无症状,随后经尸检确诊。据我们所知,这是首例因未被诊断出的卡他莫拉菌脑膜炎导致婴儿意外死亡的病例。鉴于此类致命事件的罕见性,该病例应引起儿科医生和新生儿科医生的警惕,因为卡他莫拉菌可在婴儿中引起症状轻微的脑膜脑炎,且可能具有致命性。从法医学角度来看,对于婴儿意外死亡的病例,进行尸检并辅以多学科评估以确定死因总是必要的。

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