复发性新生儿B组链球菌蜂窝织炎和腺炎综合征伴迟发性败血症

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY
A. Guri, E. Scheier, U. Balla, Mikhael Chigrinsky, Eli Shapiro
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引用次数: 0

摘要

b群链球菌(GBS)仍然是迟发性新生儿疾病的重要原因。很少表现为蜂窝组织炎-腺炎综合征,并且很少在完全康复后感染在同一婴儿中复发。这里我们报告一例复发迟发蜂窝组织炎-腺炎GBS综合征在足月12天的新生儿。婴儿表现为发烧和右颈部蜂窝织炎。全脓毒症检查正常,婴儿在抗生素治疗下完全康复。抗生素治疗结束3天后,患者因发热、毒性外观及快速扩散的蜂窝织炎和左侧颈部腺炎返回急诊科。血培养显示为GBS。病人再次入院,并成功地接受了延长疗程的抗生素治疗。结论本病例强调了将新生儿蜂窝织炎发热作为菌血症治疗的重要性,并提醒我们注意复发侵袭性GBS疾病的罕见可能性。此外,本病例说明GBS蜂窝组织炎-腺炎综合征在轻度病例中可能被误诊。医生应该意识到新生儿蜂窝织炎可以先于严重败血症的出现。发热和蜂窝织炎的新生儿没有明确的外部入境口,应进行完整的败血症检查,并接受适合菌血症的抗生素治疗,即使血培养为阴性。虽然GBS败血症的复发是罕见的,医生应该意识到这种可能性,以便及早治疗感染。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Recurrent neonatal group B streptococcus cellulitis and adenitis syndrome with late-onset sepsis
Abstract Objectives Group-B streptococcus (GBS) continues to be a significant cause of late-onset neonatal illness. Rarely does it present as cellulitis-adenitis syndrome, and rarely does the infection recur in the same infant after complete recovery. Case presentation Here we report a case of recurrent late-onset cellulitis-adenitis GBS syndrome in a term 12-day-old neonate. The infant presented with fever and cellulitis of the right neck. Full sepsis workup was normal and the infant recovered completely with antibiotics. Three days after the completion of antibiotics the patient returned to the emergency department due to fever, toxic appearance and rapidly spreading cellulitis, and adenitis on the left side of the neck. Blood culture revealed GBS. The patient was re-admitted to the hospital and successfully treated with a prolonged course of antibiotics. Conclusions This case highlights the importance of treating neonatal cellulitis with fever as bacteremia, and reminds us of the rare possibility of recurrent invasive GBS disease. Moreover, this case illustrates that GBS cellulitis-adenitis syndrome is possibly underdiagnosed in mild cases. Physicians should be aware that neonatal cellulitis can precede the appearance of severe sepsis. Neonates with fever and cellulitis without a clear external port of entry should undergo a complete sepsis workup and receive antibiotic treatment appropriate for bacteremia, even if the blood cultures are negative. Although the recurrence of GBS sepsis is rare, physicians should be aware of this possibility in order to treat the infection early.
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来源期刊
Case Reports in Perinatal Medicine
Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-
自引率
0.00%
发文量
37
期刊介绍: Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.
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