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新生儿克罗诺杆菌脑脓肿与难治性癫痫:癫痫手术的作用。病例说明

Cronobacter brain abscess and refractory epilepsy in a newborn: role of epilepsy surgery. Illustrative case.

作者信息

Yang Meredith, Tsiang John, LoPresti Melissa A, Lam Sandi

机构信息

1Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

2Department of Neurosurgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, Illinois; and.

出版信息

J Neurosurg Case Lessons. 2023 Jun 19;5(25). doi: 10.3171/CASE23140.

Abstract

BACKGROUND

Neonatal meningitis due to Cronobacter is associated with powdered infant formula. Prompt recognition of this rare but aggressive infection is critical.

OBSERVATIONS

The authors report a unique case of neonatal Cronobacter meningoencephalitis complicated by brain abscess and status epilepticus, requiring surgical intervention in a preterm 4-week-old male and related to contaminated powdered infant formula. They discuss the medical and surgical management in this patient, as well as the role of epilepsy surgery in acute drug-resistant epilepsy. This is paired with a literature review examining Cronobacter infections in infants to provide a summative review of the existing literature.

LESSONS

Cronobacter contamination in powdered infant formula and breast pumps is rare but can cause life-threatening infections. When evaluating patients with Cronobacter central nervous system infections, serial neuroimaging, infection control, and prompt surgical management are essential. Future studies are needed regarding the role of epilepsy surgery in the acute infectious period.

摘要

背景

阪崎肠杆菌引起的新生儿脑膜炎与婴儿配方奶粉有关。及时识别这种罕见但侵袭性强的感染至关重要。

观察结果

作者报告了一例独特的新生儿阪崎肠杆菌脑膜脑炎病例,该病例并发脑脓肿和癫痫持续状态,一名4周大的早产男婴需要手术干预,且与受污染的婴儿配方奶粉有关。他们讨论了该患者的内科和外科治疗,以及癫痫手术在急性耐药性癫痫中的作用。同时进行了一项文献综述,研究婴儿中的阪崎肠杆菌感染情况,以对现有文献进行总结性回顾。

经验教训

婴儿配方奶粉和吸奶器中的阪崎肠杆菌污染虽罕见,但可导致危及生命的感染。在评估阪崎肠杆菌中枢神经系统感染患者时,连续的神经影像学检查、感染控制和及时的外科治疗至关重要。关于癫痫手术在急性感染期的作用,还需要进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c727/10550530/f198da003b48/CASE23140f1.jpg

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