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重复腰椎穿刺在脑膜炎诊断中的应用

Repeat lumbar puncture in the diagnosis of meningitis.

作者信息

Kindley A D, Harris F

出版信息

Arch Dis Child. 1978 Jul;53(7):590-2. doi: 10.1136/adc.53.7.590.

DOI:10.1136/adc.53.7.590
PMID:686797
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1544988/
Abstract

Meningitis may be difficult to diagnose. If it is suspected clinically and a first lumbar puncture is normal, a second cerebrospinal fluid (CSF) sample may be required within a few hours to confirm the diagnosis. A child is presented in whom CSF was normal 14 hours after the onset of illness, but who 14 hours later showed the characteristic changes of purulent meningitis. This case differs from those previously cited in the literature, in that the blood cultures taken at the time of the first lumbar puncture were also negative.

摘要

脑膜炎可能难以诊断。如果临床上怀疑患有脑膜炎,而首次腰椎穿刺结果正常,则可能需要在数小时内采集第二份脑脊液(CSF)样本以确诊。本文介绍了一名儿童,其发病14小时后的脑脊液检查结果正常,但14小时后却出现了化脓性脑膜炎的典型变化。该病例与文献中先前引用的病例不同,在于首次腰椎穿刺时采集的血培养结果也为阴性。

相似文献

1
Repeat lumbar puncture in the diagnosis of meningitis.重复腰椎穿刺在脑膜炎诊断中的应用
Arch Dis Child. 1978 Jul;53(7):590-2. doi: 10.1136/adc.53.7.590.
2
The need to repeat lumbar puncture.
S Afr Med J. 1977 Mar 19;51(12):395-6.
3
Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment.小儿细菌性脑膜炎的腰椎穿刺:确定肠外抗生素预处理后脑脊液病原体恢复的时间间隔。
Pediatrics. 2001 Nov;108(5):1169-74.
4
Lumbar puncture in suspected neonatal sepsis.对疑似新生儿败血症进行腰椎穿刺。
J Paediatr Child Health. 1995 Feb;31(1):1-2. doi: 10.1111/j.1440-1754.1995.tb02899.x.
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Meningitis in a newborn infant with urosepsis, negative blood cultures and initially normal cerebrospinal fluid findings.
J Matern Fetal Neonatal Med. 2004 Feb;15(2):129-31. doi: 10.1080/14767050410001659860.
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The value of a repeat lumbar puncture in suspected purulent meningitis.重复腰椎穿刺在疑似化脓性脑膜炎中的价值。
J Maine Med Assoc. 1957 Jan;48(1):4-5.
7
Recognising early meningitis: a missed opportunity to diagnose meningitis.早期脑膜炎的识别:诊断脑膜炎的一个错失的机会。
BMJ Case Rep. 2016 Aug 11;2016:bcr2016214636. doi: 10.1136/bcr-2016-214636.
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Traumatic lumbar punctures in neonates: test performance of the cerebrospinal fluid white blood cell count.新生儿创伤性腰椎穿刺术:脑脊液白细胞计数的检测性能
Pediatr Infect Dis J. 2008 Dec;27(12):1047-51. doi: 10.1097/INF.0b013e31817e519b.
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Lumbar punctures and meningitis.
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[Bacterial meningitis in children: how many lumbar punctures?].[儿童细菌性脑膜炎:需要进行多少次腰椎穿刺?]
Pediatrie. 1993;48(1):17-9.

引用本文的文献

1
Varicella-Zoster meningitis with normal CSF cellularity: A rare case report.脑脊液细胞计数正常的水痘-带状疱疹性脑膜炎:一例罕见病例报告
IDCases. 2022 Mar 25;28:e01484. doi: 10.1016/j.idcr.2022.e01484. eCollection 2022.
2
A systematic review of cases of meningitis in the absence of cerebrospinal fluid pleocytosis on lumbar puncture.一项关于腰椎穿刺时无脑脊液细胞增多性脑膜炎病例的系统回顾。
BMC Infect Dis. 2019 Aug 5;19(1):692. doi: 10.1186/s12879-019-4204-z.
3
Recognising early meningitis: a missed opportunity to diagnose meningitis.早期脑膜炎的识别:诊断脑膜炎的一个错失的机会。
BMJ Case Rep. 2016 Aug 11;2016:bcr2016214636. doi: 10.1136/bcr-2016-214636.

本文引用的文献

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[Further studies on raw preserved human milk with special reference to centrifugal sterilization].[关于生鲜保存人乳的进一步研究,特别涉及离心灭菌]
Monatsschr Kinderheilkd (1902). 1960 Mar;108:119-20.
2
INTRAUTERINE GROWTH AS ESTIMATED FROM LIVEBORN BIRTH-WEIGHT DATA AT 24 TO 42 WEEKS OF GESTATION.根据孕24至42周活产儿出生体重数据估算的宫内生长情况。
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PURULENT MENINGITIS IN THE NEONATAL PERIOD.新生儿期化脓性脑膜炎
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4
Retention of nitrogen by normal full-term infants receiving an autoclaved formula.接受经高压灭菌配方奶喂养的正常足月婴儿的氮潴留情况。
Pediatrics. 1962 Jun;29:1005-11.
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The Maillard reaction.
Adv Carbohydr Chem. 1959;14:63-134. doi: 10.1016/s0096-5332(08)60223-4.
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Patterns of fat excretion in feces of premature infants fed various preparations of milk.喂养不同牛奶制剂的早产儿粪便中的脂肪排泄模式。
Pediatrics. 1960 Mar;25:375-84.
7
Fat absorption studies in children. I. Influence of heat treatment on milk on fat retention by premature infants.儿童脂肪吸收研究。I. 热处理牛奶对早产儿脂肪保留的影响。
Acta Paediatr (Stockh). 1952 May;41(3):207-21. doi: 10.1111/j.1651-2227.1952.tb17024.x.
8
Nitrogen and fat retention in premature infants fed breast milk, "humanized" cow's milk of half skimmed cow's milk.母乳喂养、半脱脂“人乳化”牛奶喂养的早产儿的氮和脂肪潴留情况
Acta Paediatr Scand. 1966 Jan;55(1):26-32. doi: 10.1111/j.1651-2227.1966.tb15205.x.
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Effect of positional distribution on the absorption of the fatty acids of human milk and infant formulas.位置分布对人乳和婴儿配方奶粉中脂肪酸吸收的影响。
J Nutr. 1968 Aug;95(4):583-90. doi: 10.1093/jn/95.4.583.
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Digestion of heat-damaged egg albumen by the rat.大鼠对热损伤蛋清的消化作用。
J Nutr. 1970 Aug;100(8):873-82. doi: 10.1093/jn/100.8.873.