Sakata H, Maruyama S
Department of Pediatrics, Asahikawa Kosei Hospital.
Kansenshogaku Zasshi. 1998 Aug;72(8):845-8. doi: 10.11150/kansenshogakuzasshi1970.72.845.
The patient was born by emergency cesarean section for fetal distress at 35 weeks gestation with a weight of 2740 g. The early neonatal course was complicated by transient tachypnea and renal failure. He was receiving oxygen and diureticus in incubator for 5 days and his condition was very improved on day 5. On day 7 he became lethargy and there was inability to tolerate feeding. Investigation of the cerebrospinal fluid revealed 8,000 leukocytes/microliter. S. marcescens was grown from cultures of both blood and cerebrospinal fluid. Treatment was started with cefotaxime and ampicillin every 6 hour. On day 14 the CT showed a brain abscess located parietooccipitally on the left side and diffuse infarction on the right side. On day 14 and 23 recurrence of increased leukocytes in the cerebrospinal fluid, high values of serum CRP and deterioration of clinical symptoms were observed. It is thought that the episodes show rupture of the abscess into the lateral ventricle. On day 55 surgical drainage was performed for the hydrocephalus. On day 110 the abscess was not found in the brain CT scan. His psychomotor development 3 years later was equivalent to two years old and he had secondary epilepsy.
该患者因胎儿窘迫于孕35周时行急诊剖宫产出生，体重2740克。新生儿早期病程并发短暂性呼吸急促和肾衰竭。他在暖箱中接受吸氧和利尿剂治疗5天，第5天时病情明显改善。第7天，他变得嗜睡，无法耐受喂养。脑脊液检查显示白细胞计数为8000/微升。从血液和脑脊液培养物中均培养出粘质沙雷菌。开始每6小时用头孢噻肟和氨苄西林进行治疗。第14天，CT显示左侧顶枕部有脑脓肿，右侧有弥漫性梗死。在第14天和第23天，观察到脑脊液中白细胞增多复发、血清CRP值升高以及临床症状恶化。据认为，这些发作表明脓肿破入侧脑室。第55天，因脑积水进行了手术引流。第110天，脑部CT扫描未发现脓肿。3年后他的精神运动发育相当于两岁儿童，并有继发性癫痫。
