Jourdan C, Convert J, Terrier A, Grando J, Mircesvki V, Mottolese C, Rousselle C, Lapras C
Département d'anesthésie-réanimation, hôpital neurologique et neurochirurgical P-Wertheimer, Lyon, France.
Pediatrie. 1993;48(10):687-91.
The authors report on three cases of staphylococcal cerebrospinal fluid (CSF) infection with normal white blood cell count and normal CSF glucose level in repeated lumbar CSF examination. All three children (2 months, 17 months and 4 years old) have been operated for neonatal hydrocephalus with setting of a ventriculo-peritoneal shunt one to two months before. Infection was suspected because of fever without evocative clinical signs. In two cases plasma C reactive protein level was increased, and in all three cases a leucocytosis was present. The diagnosis was made by bacteriological examination of the ventricular CSF. Both surgical and medical management were required and the bacteriological outcome was favourable. Since neurological sequellae may occur if the treatment is delayed such atypical infection needs to be promptly assessed.
作者报告了3例葡萄球菌性脑脊液感染病例,这些病例在多次腰椎脑脊液检查中白细胞计数正常且脑脊液葡萄糖水平正常。所有3名儿童(2个月、17个月和4岁)均因新生儿脑积水接受过手术,在术前1至2个月置入了脑室-腹腔分流管。因发热但无明确临床体征而怀疑有感染。2例患者血浆C反应蛋白水平升高,所有3例均有白细胞增多。通过脑室脑脊液的细菌学检查做出诊断。手术和药物治疗均有必要,细菌学治疗结果良好。由于如果治疗延迟可能会出现神经后遗症,因此需要及时评估这种非典型感染。