引用本文:王 菲.小儿难治性化脓性脑膜炎的临床特点及致病菌药敏分析[J].中国临床新医学,2019,12(2):200-203.
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小儿难治性化脓性脑膜炎的临床特点及致病菌药敏分析
王 菲
541002 桂林,广西壮族自治区南溪山医院小儿内科
摘要:
[摘要] 目的 分析小儿难治性化脓性脑膜炎的临床特点,并探讨相关致病因素。方法 选择2015-01~2017-06期间收治确诊为小儿难治性化脓性脑膜炎共60例,对其临床特点以及致病菌药敏进行分析。结果 60例患儿中41例可见发热症状,28例脑膜刺激征,11例巴氏征,12例皮肤红肿症,9例呼吸异常征。60例患儿脑脊液细菌学检查培养菌检出结果均为阳性,致病菌以细菌性脑膜炎常见的脑膜炎奈瑟菌、肺炎链球菌及大肠杆菌。经临床治疗后共56例患儿痊愈,3例患儿因合并真菌性脑膜炎转上级医院治疗,1例遗留微小病灶经随访6个月无复发。结论 小儿难治性化脓性脑膜炎临床表现复杂,以发热为主,常见脑膜刺激征等临床表现,多数患儿发病后白细胞计数以及C-反应蛋白检出值异常上升,经脑脊液细菌学培养检查发现脑膜炎奈瑟菌、肺炎链球菌及大肠杆菌,需要对抗生素给药方案进行合理调整,通过采用IDSA细菌性脑膜炎治疗指南进行抗菌治疗并观察临床治疗效果。
关键词:  化脓性脑膜炎  小儿  临床特点  致病因素
DOI:10.3969/j.issn.1674-3806.2019.02.22
分类号:R 725
基金项目:
Clinical characteristics of refractory purulent meningitis in children and drug susceptibility analysis of pathogenic bacteria
WANG Fei
Department of Paediatric Internal Medicine, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin 541002, China
Abstract:
[Abstract] Objective To explore the clinical features and the related pathogenic factors of refractory purulent meningitis in children. Methods A total of 60 cases of pediatric refractory purulent meningitis diagnosed during January 2015 and June 2017 were included in this study. The clinical data were retrospectively analyzed to study the clinical features and pathogenic factors of refractory purulent meningitis in children. Results Of the 60 paediatric patients, 41 cases had symptoms of fever, 28 cases had meningeal irritation, 11 cases had Babinski sign(+), 12 cases had skin irritation, and 9 cases had respiratory abnormalities. The cerebrospinal fluid bacteriological examination of bacteria was positive in all of the 60 children. The most common pathogens causing bacterial meningitis in the cerebrospinal fluid cultures were N. meningitidis, S. pneumoniae and bacillus coli. After treatment, a total of 56 children were cured, 3 children with fungal meningitis were transferred to a superior hospital. 1 case of minor lesions was followed up for 6 months and no recurrence was found. Conclusion The clinical manifestations of refractory purulent meningitis in children are mainly complicated with fever, common clinical signs such as meningeal irritation, abnormally increased leukocyte count and C-reactive protein. Such as N. meningitidis, S. pneumoniae and bacillus coli are found in CSF. Reasonable use of antibiotics should be adjusted according to the results of bacterial culture and IDSA bacterial meningitis treatment guidelines.
Key words:  Suppurative meningitis  Children  Clinical characteristics  Pathogenic factors