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细菌性脑膜炎的临床特征、诊断和治疗。

Clinical picture, diagnostics and treatment of bacterial meningitis.

机构信息

Department of Infectious Diseases and Travel Medicine, Faculty of Medicine in Pilsen, Charles University; University Hospital Pilsen, Pilsen, Czech Republic.

Emergency Medical Service of the Pilsen Region, Pilsen, Czech Republic.

出版信息

Neuro Endocrinol Lett. 2022 Dec 31;43(7-8):372-377.

Abstract

Bacterial meningitis is a serious infectious disease of the cerebral meninges, which occurs worldwide and threatens the lives of people of all ages. The largest number of cases in developed countries is caused by the gram-positive bacterium Streptococcus pneumoniae. Other more common agents are Neisseria meningitidis serotype B and Listeria monocytogenes. Fever is the most commonly reported symptom in paediatric patients, occurring in up to 93% of cases. Further, it is possible to observe headache, vomiting and positive meningeal phenomena. The most common symptoms in adults are fever, headache, positive meningeal symptoms and impaired consciousness. Examination of cerebrospinal fluid is essential for the diagnosis of bacterial meningitis. The basis of treatment is the earliest possible administration of antibiotics, initially empirically and then purposefully according to the results. Corticosteroids, traditionally dexamethasone, are also used in therapy.

摘要

细菌性脑膜炎是一种严重的脑膜感染性疾病,在全球范围内发生,威胁着各年龄段人群的生命。在发达国家,病例数量最多的是革兰阳性菌肺炎链球菌。其他更常见的病原体是脑膜炎奈瑟菌 B 型和李斯特菌单核细胞增生症。发热是儿科患者最常报告的症状,在多达 93%的病例中出现。此外,还可能观察到头痛、呕吐和脑膜刺激征阳性。成人最常见的症状是发热、头痛、脑膜刺激征阳性和意识障碍。脑脊液检查对细菌性脑膜炎的诊断至关重要。治疗的基础是尽早使用抗生素,最初是经验性的,然后根据结果有针对性地使用。皮质类固醇,传统上是地塞米松,也用于治疗。

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