Luo Lijuan, Wang Cuijin, Shen Nan, Zhao Ruike, Tao Yue, Mo Xi, Cao Qing
Department of Infectious Diseases, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Transl Pediatr. 2021 Nov;10(11):3118-3123. doi: 10.21037/tp-21-210.
Anaerobic bacterial meningitis is a rare infectious disease, and there are some special predisposing factors for it. We report a case of polymicrobial anaerobic bacterial meningitis in a nine-month-old boy who visited our hospital due to "fever with drowsiness and vomiting for 2 days". It was confirmed by the method of sanger sequencing after polymerase chain reaction (PCR) that the purulent meningitis was caused by a mixture of four anaerobic bacteria (Finegoldia magna, Campylobacter ureolyticus, Bacteroides fragilis and Porphyromonas bennonis). Even though there was no obvious structural abnormality on the skin surface, magnetic resonance imaging (MRI) examination suggested the presence of a sacrococcygeal dermal sinus. It was proven that anaerobic bacterial meningitis was secondary to retrograde infection of the dermal sinus. Finally, he was cured by a combination of anti-infection measures and surgical treatment. In conclusion, using appropriate molecular diagnostic techniques may quickly and accurately determine the pathogenic bacteria of anaerobic bacterial meningitis. When anaerobic bacterial meningitis occurs, the presence of structural abnormalities such as dermal sinus needs to be ruled out to avoid recurrence of the disease. In addition to anti-infective treatment, patients with dermal sinuses should undergo surgery as soon as possible to address abnormal structures and their root causes.
厌氧细菌性脑膜炎是一种罕见的传染病，且存在一些特殊的诱发因素。我们报告一例九个月大男孩的多微生物厌氧细菌性脑膜炎病例，该男孩因“发热伴嗜睡、呕吐2天”前来我院就诊。经聚合酶链反应（PCR）后采用桑格测序法证实，化脓性脑膜炎由四种厌氧细菌（巨大芬戈尔德菌、解脲弯曲菌、脆弱拟杆菌和本诺拟杆菌）混合感染所致。尽管皮肤表面无明显结构异常，但磁共振成像（MRI）检查提示存在骶尾部皮样窦。已证实厌氧细菌性脑膜炎继发于皮样窦的逆行感染。最后，通过抗感染措施与手术治疗相结合，患儿得以治愈。总之，使用恰当的分子诊断技术可快速、准确地确定厌氧细菌性脑膜炎的病原菌。当发生厌氧细菌性脑膜炎时，需要排除皮样窦等结构异常情况，以避免疾病复发。除抗感染治疗外，患有皮样窦的患者应尽快接受手术，以处理异常结构及其根源。
