Visudhiphan P, Chiemchanya S, Visutibhan A
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
Trans R Soc Trop Med Hyg. 1998 Mar-Apr;92(2):181-4. doi: 10.1016/s0035-9203(98)90739-8.
Between June 1988 and September 1996 12 of 65 infants (18%) admitted to the Department of Pediatrics, Ramathibodi Hospital, Bangkok, Thailand with purulent meningitis were infected with Salmonella spp. Their ages ranged from 1.5 to 6 months. Six of the infants had diarrhoea, 9 had seizures, and 11 had subdural effusion or empyema. Six infants required surgical treatment; 2 had brain abscesses. Salmonella was recovered from the cerebrospinal fluid of 11 infants and from the subdural fluid of 10. Eight infants were successfully treated with cefotaxime alone or in combination with co-trimoxazole, one with co-trimoxazole, and one with the combination of co-trimoxazole and ampicillin. The duration of treatment was 6 weeks, except for one patient who had a large brain abscess and was treated for 8 weeks. The last 2 patients, despite the fact that the organisms were susceptible to cefotaxime, failed to respond clinically to appropriate doses of it. Both were cured after ciprofloxacin was added to the therapy. Ciprofloxacin is probably the drug of choice to be used in addition to the previously used antibiotics for severe cases of Salmonella meningitis in infants.
1988年6月至1996年9月期间，泰国曼谷拉玛提波迪医院儿科收治的65例化脓性脑膜炎婴儿中有12例（18%）感染了沙门氏菌。他们的年龄在1.5至6个月之间。其中6例婴儿有腹泻，9例有惊厥，11例有硬膜下积液或积脓。6例婴儿需要手术治疗；2例有脑脓肿。11例婴儿的脑脊液和10例的硬膜下液中分离出了沙门氏菌。8例婴儿单独使用头孢噻肟或与复方新诺明联合治疗成功，1例用复方新诺明治疗成功，1例用复方新诺明与氨苄西林联合治疗成功。治疗时间为6周，除1例有巨大脑脓肿的患者接受了8周治疗外。最后2例患者，尽管病原体对头孢噻肟敏感，但对适当剂量的该药无临床反应。在治疗中加用环丙沙星后二者均治愈。对于婴儿严重沙门氏菌脑膜炎病例，除先前使用的抗生素外，环丙沙星可能是应加用的首选药物。
