Wada N, Takeuchi Y, Fujii M, Fujiwara F, Odani I, Sawada T
Department of Pediatrics, Nantan General Hospital, Yagi, Japan.
Acta Paediatr Jpn. 1994 Jun;36(3):276-9. doi: 10.1111/j.1442-200x.1994.tb03179.x.
This paper reports an 11 year old boy with bacterial meningitis accompanied by post-traumatic cerebrospinal fluid (CSF) rhinorrhea. Streptococcus pneumoniae was cultured from CSF. The clinical course was very rapid before admission and his age relatively high for usual bacterial meningitis. Consequently, we examined the cause in detail. Immunological findings were within normal limits. Although routine graphic examinations, such as cranial X-ray photography, horizontal cranial computed tomography (CT) and magnetic resonance imaging, could not demonstrate a bone defect, both coronal thin-section cranial CT scanning and radioactive isotope counting by means of cotton packed into the nasal cavity were useful for detecting CSF rhinorrhea. In a case of atypical meningitis, the past history should be examined with caution and coronal thin-section CT should be performed.
本文报道了一名11岁男孩，患有细菌性脑膜炎并伴有创伤后脑脊液鼻漏。脑脊液培养出肺炎链球菌。入院前临床病程进展非常迅速，且他的年龄对于常见的细菌性脑膜炎来说相对较大。因此，我们详细检查了病因。免疫学检查结果在正常范围内。尽管常规影像学检查，如头颅X线摄影、头颅水平计算机断层扫描（CT）和磁共振成像，均未显示骨缺损，但冠状位薄层头颅CT扫描以及通过鼻腔内填塞棉球进行放射性同位素计数，对于检测脑脊液鼻漏均有帮助。对于非典型脑膜炎病例，应谨慎询问既往史并进行冠状位薄层CT检查。
