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[小儿细菌性脑膜炎。166例病例研究]

[Bacterial meningitis in pediatrics. Study of 166 cases].

作者信息

Fernández-Jaén A, Borque Andrés C, del Castillo Martín F, Peña García P, Vidal López M L

机构信息

Hospital Infantil La Paz, Servicio de Infecciosos, Universidad Autónoma de Madrid.

出版信息

An Esp Pediatr. 1998 May;48(5):495-8.

PMID:9656536
Abstract

OBJECTIVE

The purpose of this study was to evaluate the clinical and epidemiological characteristics of meningitis in our environment.

PATIENTS AND METHODS

A retrospective study of 166 cases of meningitis diagnosed in our hospital during a 10 year period (1986-1995) was performed. The patients were between 1 month and 14 years of age.

RESULTS

Sixty-six percent of the patients were male and 34% female. Eleven cases were younger than 2 months (6.6%), 122 cases (73.5%) were between 3 months and 5 years of age and 33 cases (19.9%) were older than 5 years. The most frequent symptoms and signs were fever (96%), vomiting (60%), impairment of consciousness (24%) and meningeal signs (49%). CSF cultures were positive in 52% and blood cultures in 32%. The pathogen isolated was N. meningitidis in 53 cases (32%), H. influenzae in 38 (23%), S. pneumoniae in 9 patients (5%) and others in 3 children (2%). Meningitis due to H. influenzae increased each year. No microorganism was isolated in blood and CSF in 63 cases (38%). Meningitis in children between 3 months and 5 years of age was due to N. meningitidis in 40 children (33%) and H. influenzae in 36 (29%). The mortality rate was 3%. The most frequent complications were sepsis (36%) and seizures (16%).

CONCLUSIONS

The most frequently isolated agent in our study was N. meningitis. Meningitis due to H. influenzae is increasing such that H. influenzae and N. meningitis currently show similar frequency in children between 3 months and 5 years of age.

摘要

目的

本研究旨在评估我们所处环境中脑膜炎的临床和流行病学特征。

患者与方法

对我院在10年期间(1986 - 1995年)诊断的166例脑膜炎病例进行回顾性研究。患者年龄在1个月至14岁之间。

结果

66%的患者为男性,34%为女性。11例患者年龄小于2个月(6.6%),122例(73.5%)年龄在3个月至5岁之间,33例(19.9%)年龄大于5岁。最常见的症状和体征为发热(96%)、呕吐(60%)、意识障碍(24%)和脑膜刺激征(49%)。脑脊液培养阳性率为52%,血培养阳性率为32%。分离出的病原体中,53例(32%)为脑膜炎奈瑟菌,38例(23%)为流感嗜血杆菌,9例(5%)为肺炎链球菌,3例儿童(2%)为其他病原体。流感嗜血杆菌所致脑膜炎逐年增加。63例(38%)患者的血液和脑脊液中未分离出微生物。3个月至5岁儿童的脑膜炎,40例(33%)由脑膜炎奈瑟菌引起,36例(29%)由流感嗜血杆菌引起。死亡率为3%。最常见的并发症为败血症(36%)和惊厥(16%)。

结论

我们研究中最常分离出的病原体是脑膜炎奈瑟菌。流感嗜血杆菌所致脑膜炎呈上升趋势,目前在3个月至5岁儿童中,流感嗜血杆菌和脑膜炎奈瑟菌所致脑膜炎的发生率相近。

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