新生儿多发性脑脓肿:罕见病例报告及文献综述

Aanand Mehta, Manish Yadav, Bishal Kumar Gupta, Bikash Thapa, Junu Rai, Surya Bahadur Thapa, Sudip Kumar Yadav, Digraj Yadav, Mohan Raj Sharma
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引用次数: 0

摘要

脑脓肿是由各种微生物引起的脑实质化脓性感染。多发性脑脓肿在新生儿中并不常见,白色念珠菌作为致病菌也非常罕见。如果不及时治疗,脑脓肿总是致命的。早期诊断、及时手术治疗、同时根除原发病源和大剂量静脉注射抗生素可降低发病率和死亡率。 一名出生 20 天的新生儿,正常足月分娩,APGAR 评分满分,5 天前出现发热、活动减少、黄疸和惊厥。影像学检查发现多个脑囊肿,诊断为多发性脑脓肿。治疗包括术中 USG 引导下的毛细孔引流,随后进行为期 6 周的抗真菌治疗。经显微镜检查和脓液培养,发现白色念珠菌是致病菌。 这篇文献强调了新生儿多发性脑脓肿真菌感染的罕见性。处理这类病例非常具有挑战性,因为其表现可能与细菌感染相似。在治疗决策中将真菌视为致病菌至关重要。 真菌引起的多发性脑脓肿极为罕见。及早发现和处理病例可以降低新生儿的死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multiple brain abscesses in a neonate:a rare case report along with review of literature
Brain abscess is a pyogenic infection of the brain parenchyma caused by various organisms. Multiple brain abscesses are uncommon in neonates, and Candida albicans as a causative agent is very rare. If left untreated, brain abscesses are invariably fatal. Early diagnosis, prompt surgical intervention, simultaneous eradication of the primary source, and high-dose intravenous antibiotics decrease the incidence of morbidity and mortality. A 20-day-old newborn, delivered normally at term with a full APGAR score, presented with a 5-day history of fever, decreased activity, jaundice, and seizures. Imaging identified multiple cerebral cysts, diagnosed as multiple cerebral abscesses. Treatment involved intraoperative USG-guided burr hole drainage, followed by a 6-week antifungal therapy course. Candida albicans was found to be the causative organism following microscopic examination and culture of the pus. This literature highlights the rarity of fungal involvement in multiple cerebral abscesses in neonates. Managing such cases is very challenging, as the presentation may mimic bacterial infections. The importance of considering fungi as a causative agent in treatment decisions is crucial. Multiple brain abscesses of fungal origin are extremely rare. Early detection and management of cases can reduce mortality among neonates.
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