心绞痛链球菌群引起的中枢神经系统疾病谱：单中心病例系列

IF 2.1 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-05-26 DOI:10.1016/j.pediatrneurol.2025.05.022

Jennifer Meylor MD , Raquel Farias-Moeller MD , Niyati Mehta MD , Rachel Sawdy DNP, CPNP-AC , Namrata D. Patel MD, MS

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引用次数: 0

摘要

研究背景：探讨心绞痛链球菌（SAG）继发性中枢神经系统感染患儿的电生理和神经学预后。方法我们报告了15例因SAG引起中枢神经系统感染而入住儿科重症监护病房（PICU）的患儿的回顾性病例系列。结果患者健康，就诊前无明显合并症。前驱症状为急性发作（不到四周），大多数患者出现发热（93%）、头痛（87%）和疲劳（87%）。14例（93%）有硬膜下或硬膜外脓肿，1例（7%）有脑室炎。9例（60%）患者行连续脑电图记录。7例患者（47%）有癫痫发作，3例患者（20%）仅有亚临床癫痫发作。1例患者（7%）发生癫痫。5例患者（33%）在出院时的神经学检查中有轻度至中度残留缺陷。神经心理测试显示情绪失调（如情绪反应、焦虑、抑郁）、注意力缺陷和工作记忆困难。结论：在我们的队列中，患者以前是健康的，急性发作的非特异性症状。住院通常伴有颅内脓肿和癫痫发作；预后良好，只有三分之一的患者在出院时出现神经功能障碍。神经心理学数据显示PICU入院后明显的心理缺陷。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Spectrum of Central Nervous System Disease Caused by Streptococcus anginosus Group: A Single-Center Case Series

Background

To characterize the electrophysiologic and neurological outcomes of pediatric patients with central nervous system infections secondary to Streptococcus anginosus group (SAG).

Methods

We report a retrospective case series of 15 pediatric patients admitted to the pediatric intensive care unit (PICU) with central nervous system infections caused by SAG.

Results

The population was healthy with no significant comorbidities before presentation. Prodromal symptoms had an acute onset (less than four weeks), with most patients experiencing fever (93%), headache (87%), and fatigue (87%). Fourteen patients (93%) had subdural or epidural empyema, while one (7%) had ventriculitis. Nine patients (60%) underwent continuous electroencephalography recording. Seven patients (47%) had seizures, with three patients (20%) having subclinical seizures only. One patient (7%) developed epilepsy. Five patients (33%) had mild to moderate residual deficits on neurological examination at discharge. Neuropsychologic testing revealed emotional dysregulation (e.g., emotional reactivity, anxiety, depression), attention deficits, and difficulty with working memory.

Conclusions

Among our cohort, patients were previously healthy with acute onset of nonspecific symptoms. Hospitalization was typically complicated by intracranial abscesses and seizures; the prognosis was favorable, with only one third of patients experiencing neurological deficits at discharge. Neuropsychologic data showed notable psychological deficits following PICU admission.

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.