Effect of the NMDA-receptor antagonist dextromethorphan in infant rat pneumococcal meningitis

Excitatory amino acids (EAA) and particularly glutamate toxicity have been implicated in the pathogenesis of neuronal injury occurring in bacterial meningitis by activating the N-methyl-d aspartate (NMDA) receptor complex. Here, we evaluated the effect of adjuvant treatment with the antitussive drug dextromethorphan (DM), a non-competitive NMDA receptor antagonist with neuroprotective potential, in an infant rat model of pneumococcal meningitis. The experiments were carried out in postnatal day 6 (P6) and 11 (P11) animals. Pharmacokinetics of DM and its major metabolite dextrorphan (DO) were performed for dose finding. In our study, DM did not alter clinical parameters (clinical score, motor activity, incidence of seizures, spontaneous mortality) and cortical neuronal injury but increased the occurrence of ataxia (P<0.0001). When DM treatment was started at the time of infection (DM i.p. 15 mg/kg at 0, 4, 8 and 16 hours (h) post infection) in P11 animals, an aggravation of apoptotic neuronal death in the hippocampal dentate gyrus was found (P<0.05). When treatment was initiated during acute pneumococcal meningitis (DM i.p. 15 mg/kg at 12 and 15 h and 7.5 mg/kg at 18 and 21 h after infection), DM had no effect on the extent of brain injury but reduced the occurrence of seizures (P<0.03). We conclude that in this infant rat model of pneumococcal meningitis interference of the EEA and NMDA pathway using DM causes ataxia, attenuates epileptic seizures and increases hippocampal apoptosis, but is not effective in protecting the brain from injury.     

Salmonella meningitis and multiple cerebral abscesses in an infant

The history of a 4-week-old infant with meningitis and multiple cerebral abscesses caused by Salmonella enteritidis is reported. Management included successful treatment with a prolonged course of antibiotics, including ciprofloxacin, neurosurgical drainage and long-term immunoglobulin supplements. No adverse effects of joint toxicity were detected.     

Rifampicin+ceftriaxone versus vancomycin+ceftriaxone in the treatment of penicillin- and cephalosporin-resistant pneumococcal meningitis in an experimental rabbit model

This study was planned to compare the efficacy of ceftriaxone+vancomycin with ceftriaxone+rifampicin in a rabbit model of penicillin and cephalosporin-resistant Streptococcus pneumoniae meningitis. Meningitis was induced by intracisternal inoculation of S. pneumoniae. After 18 h of incubation, Group 1 was given saline solution (control group), whilst Groups 2 and 3 were given ceftriaxone+vancomycin and ceftriaxone+rifampicin, respectively. Cerebrospinal fluid bacterial concentrations were measured at 0, 2, 12, 14 and 24 h after therapy was initiated. In the control group, bacterial growth was present at all time points, whereas no growth was observed in either the ceftriaxone+vancomycin group or the ceftriaxone+rifampicin group after 2 h of therapy. Ceftriaxone+rifampicin was found to be as effective as ceftriaxone+vancomycin in the treatment of penicillin-resistant S. pneumoniae meningitis in experimental rabbit model.     

乳酸菌素片致婴儿血尿

患儿男,10个月,因发热、腹泻来院就诊.经查给予10%葡萄糖注射液250ml+10%氯化钠注射液5ml+利巴韦林(病毒唑)针剂0.1g,qd,静滴,同时给予乳酸菌素片0.2g tid,po,当天晚上即出现血尿.     

An experimental meningitis with Streptococcus pneumoniae in rats: therapeutic effect of aspoxicillin and its penetration into CSF

An experimental meningitis model was produced in rats with Streptococcus pneumoniae Type III and used to evaluate the therapeutic effect of aspoxicillin in comparison with piperacillin, mezlocillin and ampicillin. At the same time, their bactericidal activities and pharmacokinetics in cerebrospinal fluid (CSF) were determined. The experimental meningitis model was prepared by intracisternal inoculation of the organism. The rats in this model began to die 2 days after the infection and all died within 5 days. Histological examination also revealed that this model was a fatal pneumococcal meningitis model in rats. The concentrations of these penicillins in CSF of the infected rats determined by the high performance liquid chromatography method were significantly increased by bacterial infection. Of these drugs, ASPC gave the highest penetration into the infected CSF and the longest persistency in CSF. In a comparison of the bactericidal activity of these penicillins in this model, aspoxicillin at a dose of 20 mg/kg inhibited the regrowth of bacteria in CSF 24 h after administration, but the other three penicillins did not. To conclude, in this new experimental meningitis model in rats, aspoxicillin showed an excellent therapeutic effect due to its stronger bactericidal action and favourable pharmacokinetic properties.     

An attempt to induce neurotoxicity in an infant rhesus monkey with monosodium glutamate

The administration of monosodium glutamate (MSG) to an infant (2-day-old) rhesus monkey at a dose level of 4 g/kg, in 10 ml SMA baby milk, failed to induce any pathological change in the hypothalamus.     

制霉菌素口腔黏膜给药致手足口病婴儿过敏性休克

1例7个月男婴因手足口病入院.住院后因并发霉菌性口炎,给予制霉菌素100万U溶于0.9%氯化钠注射液10 ml中涂于口腔黏膜局部,并静脉滴注痰热清注射液.之后,婴儿出现哭闹、四肢抽动,皮肤发绀及高热,BP 80/55 mm Hg,HR 160次/min.经抗过敏药物治疗后症状缓解.2 d后停用痰热清注射液,再次使用制霉菌素治疗,患儿再次出现紫绀、四肢厥冷,BP 70/50 mm Hg.停用制霉菌素,改为氟康唑治疗,上述症状未再发生.     

Hyperaldosteronemia and hypogammaglobulinemia secondary to atopic dermatitis-induced exudation in an infant presenting with growth failure

The present case is a 5-month-old female with atopic dermatitis who was brought to hospital for growth failure noted upon regular health examination. Laboratory examinations revealed hyponatremia, hyperkalemia, hypoproteinemia, hypogammaglobulinemia, elevated plasma renin activity and hyperaldosteronemia. Immune function was normal. Composition of the exudate collected from the skin lesions of atopic dermatitis was similar to that of plasma. Application of a steroid ointment improved the lesions as well as all laboratory values. These findings indicate that voluminous exudation caused by extensive atopic dermatitis can lead to hypotonic dehydration, electrolyte abnormalities, hypoproteinemia, hypogammaglobulinemia and, finally, to growth failure in infants. We conclude that intensive treatment is important for severe atopic dermatitis in infants to prevent serious complications.     

Mechanisms leading to hypogonadism in men with burns injuries.

A profound and persistent depression of serum testosterone concentrations was found in 19 men with burns injuries. This could not be explained by changes in sex hormone binding globulin capacity, hyperprolactinaemia, classical primary testicular failure, or a hypogonadotrophic state. Pulsatile release of luteinising hormone was found in control subjects but was absent or diminished in burnt patients with low serum testosterone concentrations. In addition, these patients showed reduced biological activity of luteinising hormone as measured by bioassay even though normal concentrations of luteinising hormone were detected by radioimmunoassay. The temporary hypogonadism after burns injury and possibly in other clinical states may be related to hypothalamic dysfunction, which leads to abnormal generation of luteinising hormone releasing hormone and non-pulsatile secretion of luteinising hormone of reduced biological activity.     

以结节样皮疹为首发表现的先天性急性单核细胞性白血病1例

患儿,女性,40d,出生后20d开始在颜面、躯干等部位出现紫兰色皮肤结节、斑块,无发热及出血。经血液和骨髓穿刺证实为急性髓性白血病M5,皮损处组织病理和免疫组化呈皮肤白血病改变。患儿明确诊断后放弃治疗,2周后死亡。     

强脉冲光联合硅胶膜片行颜面外伤早期抗瘢痕治疗

目的:应用强脉冲光联合硅胶膜片行颜面外伤早期预防和抗瘢痕治疗.方法:应用武汉奇致公司生产的IPLQUEE强脉冲光子治疗仪,输出能量密度为20～23 J/cm2,光斑面积8mm×34mm,治疗参数560nm脉宽:2～6ms.每4周一次,进行强脉冲光治疗,4～6次为一疗程.硅胶膜片为:瘢痕敌胶片.于瘢痕形成部位外贴,每天8h以上,连续应用3～6月.结果:利用强脉冲光能穿透皮肤,被创伤部位异常增生的毛细血管选择性吸收并转化为热能的特性,使血管快速封闭,成纤维细胞变性减少,同时强光可使创伤后皮肤沉着的色素裂解,从而被自体组织吸收、代谢;由此使瘢痕平软,红斑、色素减退.同时,硅胶膜使瘢痕水分蒸发减少,皮肤内水分转移到角质层,间质水溶性物质减少,流体力学压力下降,瘢痕组织因而软化.27例患者中,15例痊愈,12例有效.结论:认为强脉冲光联合硅胶膜片行颜面外伤早期预防和抗瘢痕治疗是一种疗效好的方法.