Feldman W E
Am J Dis Child. 1976 Aug;130(8):880-3. doi: 10.1001/archpedi.1976.02120090090017.
Two patients with Bacteroides fragilis meningitis and ventriculitis were treated. In one infant infection developed at 2 1/2 months of age as a result of an infected ventriculoatrial shunt inserted to treat hydrocephalus. In the second patient ventriculitis and meningitis developed at 20 days of age, while he was convalescing from surgery for gastric perforation that had occurred at 5 days of age. Both patients were treated with ampicillin, chloramphenicol, and clindamycin, which sterilized the blood and lumbar cerebrospinal fluid but not the ventricular cerebrospinal fluid. The first patient received no further antibiotic therapy and died at 5 months of age. Metronidazole therapy sterilized the ventricular fluid of the second patient, who survived the infection. Ventriculitis should be suspected in patients with B fragilis meningitis. A brain scan should be done to detect signs of ventriculitis or brain abscess. Metronidazole may be the drug of choice in patients with B fragilis ventriculitis or meningitis who do not respond to chloramphenicol.
两名患有脆弱拟杆菌性脑膜炎和脑室炎的患者接受了治疗。其中一名婴儿在2个半月大时因插入用于治疗脑积水的感染性脑室心房分流管而发生感染。第二名患者在20日龄时发生脑室炎和脑膜炎，当时他正在从5日龄时发生的胃穿孔手术中恢复。两名患者均接受了氨苄西林、氯霉素和克林霉素治疗，这些药物使血液和腰椎脑脊液无菌，但脑室脑脊液未无菌。第一名患者未接受进一步的抗生素治疗，于5个月大时死亡。甲硝唑治疗使第二名患者的脑室液无菌，该患者在感染中幸存。对于患有脆弱拟杆菌性脑膜炎的患者，应怀疑有脑室炎。应进行脑部扫描以检测脑室炎或脑脓肿的迹象。对于对氯霉素无反应的脆弱拟杆菌性脑室炎或脑膜炎患者，甲硝唑可能是首选药物。
