摘要
目的探讨新生儿B族链球菌(GBS)败血症合并化脓性脑膜炎的临床特点。方法回顾性分析2010—2012年深圳市人民医院新生儿病房住院的5例GBS败血症合并化脓性脑膜炎患儿的一般资料、临床特征、实验室检查结果、影像学检查结果、治疗及转归。结果 5例GBS败血症合并化脓性脑膜炎患儿,均顺产、足月、无异常出生史。1例早发型病例以黄疸为首发症状,4例晚发型病例均发热伴不同程度的神经系统异常症状。2例患儿白细胞计数减低、1例升高,C反应蛋白水平均明显增高,均对青霉素及万古霉素敏感。5例患儿给予综合治疗后存活,脑干诱发电位均通过。2例患儿颅脑磁共振成像(MRI)提示:脑软化灶,1例患儿有少许出血灶,余2例正常。随访1年,1例有生长发育滞后,余4例生长发育正常。结论新生儿GBS败血症合并化脓性脑膜炎的临床特点各异,须引起重视。对于可疑患儿应早期进行血培养确定病原菌,行脑脊液检查,尽早用敏感抗生素治疗,减少后遗症的发生。
Objective To explore clinical characteristics of neonates with group B streptococcal （GBS） septicemia and purulent meningitis （PM）. Methods The general data, clinical features, laboratory and imaging findings, treatment and prognosis of neonates with GBS septicemia admitted to this hospital from 2010 to 2012 were analyzed retrospectively. Results Five infants were diagnosed as GBS septicemia and purulent meningitis and all were vaginal delivery, full term without abnormal birth history. One early - onset case had jaundice as the first symptom, 4 late - onset case had fever complicated by different de- grees of neurological abnormalities. Leukocyte count decreased in 1 infant, increased in 1. C - reactive protein increased re- markably, which was sensitive to penicillin and vancomycin. Five patients were given combined treatment and survived, brain- stem evoked potentials were passed. Brain magnetic resonance imaging （MRI） demonstrated encephalodialysis in 2 patients, a few bleeding nidi in 1, the other 2 were normal. After 1 year of follow - up, 1 had growth retardation, the other 4 were normal. Conclusion Neonatal GBS septicemia with purulent meningitis, which clinical features are different. The suspected neonates should have blood cultures to confirm pathogen and cerebrospinal fluid examination as soon as possible, to undergo sensitive anti- biotics to reduce incidence of complications.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第23期2750-2752,共3页
Chinese General Practice
关键词
婴儿
新生
链球菌
无乳
脑膜炎
细菌性
Infant, newborn
Streptococcus agalactiae
Meningitis, bacterial
