Saulnier J P, Nassimi A, Cardona J, Gambert C, Barret D, Berthier M, Levard G, Oriot D
Service de Pédiatrie, CHU, Poitiers, France.
Arch Pediatr. 1998 Jun;5(6):641-3. doi: 10.1016/s0929-693x(98)80171-1.
Cases of meningitis due to Bacteroides fragilis are rare; we report a case revealing a meningorectal fistula.
A 2-month-old infant developed a severe sepsis syndrome following a rectosigmoidoscopy for rectal bleeding. Lumbar puncture diagnosed bacterial meningitis. Cerebrospinal fluid (CSF) culture evidenced B fragilis with betalactamase. The initial antibiotherapy was changed for imipenem-metronidazole, which is at present the recommended antibiotherapy. Malformation including pre-spinal tumor and meningorectal fistula was evoked on magnetic resonance imaging (MRI) and confirmed by surgery. The outcome was favorable after surgery and antibiotherapy.
B fragilis meningitis are usually associated with sepsis, whose origin is obvious. In our case, meningitis was isolated, revealing a meningorectal fistula.
脆弱拟杆菌引起的脑膜炎病例罕见；我们报告一例揭示了脑膜直肠瘘的病例。
一名2个月大的婴儿在因直肠出血进行乙状结肠镜检查后出现严重脓毒症综合征。腰椎穿刺诊断为细菌性脑膜炎。脑脊液（CSF）培养证实为产β-内酰胺酶的脆弱拟杆菌。最初的抗菌治疗改为亚胺培南-甲硝唑，这是目前推荐的抗菌治疗方法。磁共振成像（MRI）检查发现包括脊柱前肿瘤和脑膜直肠瘘在内的畸形，并经手术证实。手术和抗菌治疗后预后良好。
脆弱拟杆菌脑膜炎通常与脓毒症相关，其病因明显。在我们的病例中，脑膜炎是孤立出现的，揭示了脑膜直肠瘘。
