Fernández-Jaén A, Calleja-Pérez B, Martínez-Bermejo A, Borque C, Pascual-Castroviejo I
Servicio de Infecciosos, Hospital Infantil La Paz, Madrid, España.
Rev Neurol. 1997 Dec;25(148):1886-9.
Studying clinical, laboratory and radiologic findings, as well as outcome, observed in patients with meningitis caused by Hib, and its relationship with subdural effusion.
Retrospective study of 38 meningitis caused by Hib. Patients were aged between 3 months and 5 years. Imaging was performed in 26 cases (68%): CT in 21 children (55%) and cranial sonography in 11 cases (29%). EEG was made in 29 patients (76%) and auditory-evoked potentials in 13 (34%). The mean follow-up period after discharge was 24 months.
Sixty-six per cent were male and 34% female. Eight cases had subdural effusion. These patients showed higher white cell counts in blood and CSF, higher levels of proteins in CSF, and lower levels of glucose in the same medium. They also had seizures before or during hospitalization, with higher frequency than those without subdural effusion (50% vs 26%) as well as more prolonged fever (127 vs 73 hours). No specific treatment was required in any case.
Subdural effusion is one of the most frequent complications observed in meningitis. Patients frequently present more important clinical and laboratory alterations. This finding is not related with neurologic sequelae and they resolve spontaneously with time.
研究由b型流感嗜血杆菌(Hib)引起的脑膜炎患者的临床、实验室和影像学表现以及预后,及其与硬膜下积液的关系。
对38例由Hib引起的脑膜炎进行回顾性研究。患者年龄在3个月至5岁之间。26例(68%)进行了影像学检查:21例儿童(55%)进行了CT检查,11例(29%)进行了头颅超声检查。29例患者(76%)进行了脑电图检查,13例(34%)进行了听觉诱发电位检查。出院后的平均随访期为24个月。
男性占66%,女性占34%。8例有硬膜下积液。这些患者血液和脑脊液中的白细胞计数更高,脑脊液中的蛋白质水平更高,同一介质中的葡萄糖水平更低。他们在住院前或住院期间也有癫痫发作,发作频率高于无硬膜下积液的患者(50%对26%),发热时间也更长(127小时对73小时)。在任何情况下都不需要特殊治疗。
硬膜下积液是脑膜炎中最常见的并发症之一。患者经常出现更重要的临床和实验室改变。这一发现与神经后遗症无关,且会随着时间自发消退。