胆溶血性链球菌巴氏亚种引起的婴儿细菌性脑膜炎合并败血症:病例报告。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Dan Zou, Fen Li, Shu-Li Jiao, Jin-Rong Dong, Yao-Yao Xiao, Xiao-Ling Yan, Yan Li, Dan Ren
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引用次数: 0

摘要

背景:胆溶血性链球菌巴氏亚种(SGSP)是一种导致婴儿败血症和脑膜炎的罕见病原体,由于未被纳入常规 B 组链球菌筛查,因此有可能被忽视。因此,我们介绍了一例由 SGSP 引起的婴儿脑膜炎和败血症,并伴有由耐多药金黄色葡萄球菌(MRSA)引起的支气管肺炎,为这种细菌感染的识别、管理和预后提供了见解。病例摘要:一名 45 天大的女婴因两次高烧(最高体温:39.5 °C)和两次全身性癫痫大发作而入院。入院后,患者的 C 反应蛋白水平为 40.73 mg/L,白细胞计数为 13.42 × 109/L,中性粒细胞比率为 78.4%,降钙素原水平为 7.89 μg/L,脑脊液(CSF)白细胞计数为 36 × 106/L,多核细胞比率为 95.2%,蛋白质浓度为 0.41 g/L。血液和脑脊液培养显示病原体为 SGSP。该细菌对氨苄西林、呋喃唑酮、青霉素、林可霉素、莫西沙星、利福平、万古霉素和左氧氟沙星敏感,但对克林霉素和四环素耐药。痰培养显示存在 MRSA,它对万古霉素敏感。患者被诊断为由 SGSP 引起的脑膜炎和败血症,并伴有由 MRSA 引起的支气管肺炎。入院后给予头孢曲松(100 mg/kg/d)联合万古霉素(10 mg/kg/d,q6h)作为抗感染治疗。治疗 12 天后,婴儿出院,CSF、血培养和血常规检查结果正常,头颅计算机断层扫描未发现硬膜下积液等并发症。随访期间未出现生长迟缓或神经系统后遗症:结论:SGPSP 引起的婴儿细菌性脑膜炎和败血症应及时进行血液和脑脊液培养,并使用敏感的抗生素治疗,以确保良好的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Infantile bacterial meningitis combined with sepsis caused by Streptococcus gallolyticus subspecies pasteurianus: A case report.

Background: Streptococcus gallolyticus subspecies pasteurianus (SGSP) is a rare pathogen responsible for infant sepsis and meningitis and is potentially overlooked because it is not included in routine group B streptococcal screenings. Hence, we present a case of SGSP-induced infant meningitis and sepsis, accompanied by bronchopneumonia induced by multidrug-resistant Staphylococcus aureus (MRSA), providing insights into the identification, management, and prognosis of this bacterial infection.

Case summary: A 45-day-old female infant presented with two episodes of high fever (maximum temperature: 39.5 °C) and two generalized grand mal seizure episodes that lasted over ten seconds and self-resolved without concomitant symptoms. Postadmission, the patient's C-reactive protein level was 40.73 mg/L, white blood cell count was 13.42 × 109/L, neutrophil ratio was 78.4%, procalcitonin level was 7.89 μg/L, cerebrospinal fluid (CSF) white cell count was 36 × 106/L, multinucleated cell ratio was 95.2%, and protein concentration was 0.41 g/L. Blood and CSF culture revealed that the pathogen was SGSP. The bacterium was sensitive to ampicillin, furazolidone, penicillin, lincomycin, moxifloxacin, rifampicin, vancomycin, and levofloxacin but resistant to clindamycin and tetracycline. Sputum culture revealed the presence of MRSA, which was sensitive to vancomycin. The patient was diagnosed with meningitis and sepsis caused by SGSP, accompanied by bronchopneumonia induced by MRSA. Ceftriaxone (100 mg/kg/d) combined with vancomycin (10 mg/kg/dose, q6h) was given as an anti-infective treatment postadmission. After 12 days of treatment, the infant was discharged from the hospital with normal CSF, blood culture, and routine blood test results, and no complications, such as subdural effusion, were observed on cranial computed tomography. No growth retardation or neurological sequelae occurred during follow-up.

Conclusion: SGPSP-induced infant bacterial meningitis and sepsis should be treated with prompt blood and CSF cultures, and a sensitive antibiotic therapy to ensure a favorable prognosis.

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来源期刊
World Journal of Clinical Cases
World Journal of Clinical Cases Medicine-General Medicine
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3384
期刊介绍: The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.
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