Chiu C H, Lin T Y, Huang Y C
Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Scand J Infect Dis. 1995;27(1):75-6. doi: 10.3109/00365549509018977.
A previously healthy 30-day-old male infant became ill with fever, poor activity, and refusal to feed for 2 days. A cerebrospinal fluid examination revealed 7.15 x 10(8) leukocytes/l with 72% neutrophils, protein 4.6g/l, and glucose 7 mg/dl. Neisseria meningitidis was isolated from the blood and cerebrospinal fluid. On the fourth day of hospitalization, the baby was found to have left oculomotor and facial palsies, which resolved gradually. He was treated with intravenous penicillin for 2 weeks. A repeat CSF examination revealed a high persisting protein level of 2.9 g/l and a computerized tomographic brain scan revealed a cerebral infarction in the bilateral frontal lobes. The treatment was extended to 4 weeks. No relapse of the infection was noted. This is the first case report of an infant with meningococcal meningitis complicated by cranial nerve palsies and cerebral infarction. This and previous reports, show that meningococcal meningitis at an extremely young age is associated with a greater risk of developing neurological complications.
一名此前健康的30日龄男婴出现发热、活动减少及拒食2天。脑脊液检查显示白细胞计数为7.15×10⁸/L，中性粒细胞占72%，蛋白4.6g/L，葡萄糖7mg/dl。血液和脑脊液中分离出脑膜炎奈瑟菌。住院第4天，发现患儿有左侧动眼神经和面神经麻痹，后逐渐缓解。给予静脉滴注青霉素治疗2周。复查脑脊液显示蛋白水平持续较高，为2.9g/L，脑部计算机断层扫描显示双侧额叶脑梗死。治疗延长至4周。未发现感染复发。这是首例关于婴儿患脑膜炎球菌性脑膜炎并发脑神经麻痹和脑梗死的病例报告。本病例及既往报告表明，极年幼患儿患脑膜炎球菌性脑膜炎发生神经并发症的风险更高。
