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新生儿多发性脑脓肿:一例罕见病例报告并文献复习

Multiple brain abscesses in a neonate: a rare case report along with review of literature.

作者信息

Mehta Aanand, Yadav Manish, Gupta Bishal K, Thapa Bikash, Rai Junu, Thapa Surya B, Yadav Sudip K, Yadav Digraj, Sharma Mohan R

机构信息

Tribhuvan University Teaching Hospital, Maharajgunj.

Maharajgunj Medical Campus, Tribhuvan University.

出版信息

Ann Med Surg (Lond). 2024 May 17;86(8):4793-4798. doi: 10.1097/MS9.0000000000002155. eCollection 2024 Aug.

Abstract

INTRODUCTION AND IMPORTANCE

Brain abscess (BA) is a pyogenic infection of the brain parenchyma caused by various organisms. Multiple BAs are uncommon in neonates, and as a causative agent is very rare. If left untreated, BAs are invariably fatal. Early diagnosis, prompt surgical intervention, simultaneous eradication of the primary source, and high-dose intravenous antibiotics decrease the incidence of morbidity and mortality.

CASE PRESENTATION

A 20-day-old newborn, delivered normally at term with a full APGAR score, presented with a 5-day history of fever, decreased activity, jaundice, and seizures. Imaging identified multiple cerebral cysts, diagnosed as multiple cerebral abscesses. Treatment involved intraoperative USG-guided burr-hole drainage, followed by a 6-week antifungal therapy course. was found to be the causative organism following microscopic examination and culture of the pus.

CLINICAL DISCUSSION

This literature highlights the rarity of fungal involvement in multiple cerebral abscesses in neonates. Managing such cases is very challenging, as the presentation may mimic bacterial infections. The importance of considering fungi as a causative agent in treatment decisions is crucial.

CONCLUSION

Multiple BAs of fungal origin are extremely rare. Early detection and management of cases can reduce mortality among neonates.

摘要

引言与重要性

脑脓肿(BA)是由多种病原体引起的脑实质化脓性感染。新生儿多发性脑脓肿并不常见,且作为病原体极为罕见。若不治疗,脑脓肿必然致命。早期诊断、及时的手术干预、同时根除原发感染源以及大剂量静脉使用抗生素可降低发病率和死亡率。

病例介绍

一名20日龄足月顺产新生儿,阿氏评分满分,出现发热、活动减少、黄疸和惊厥5天。影像学检查发现多个脑囊肿,并诊断为多发性脑脓肿。治疗包括术中超声引导下钻孔引流,随后进行为期6周的抗真菌治疗。经脓液显微镜检查和培养,发现 为病原体。

临床讨论

该文献强调了真菌引起新生儿多发性脑脓肿的罕见性。处理此类病例极具挑战性,因为临床表现可能与细菌感染相似。在治疗决策中考虑真菌作为病原体的重要性至关重要。

结论

真菌源性多发性脑脓肿极为罕见。早期发现和处理此类病例可降低新生儿死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee3e/11305707/75bee55a534d/ms9-86-4793-g001.jpg

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