Mollaret''''s脑膜炎1例报告

临床资料 患儿,女,11岁,因咳嗽10 d,发热、阵发性 头痛7 d,加重伴呕吐半天入院。无抽搐、意识障碍。曾于2年 及6个月前因发热、头痛先后2次住院,诊断为"化脓性脑膜 炎"治愈出院。查体:T 37.2℃,神志清楚,脑膜刺激征阳性,余 神经系统检查未见异常。实验室检查:血WBC 14.9×109／L,N 0.55,L 0.36。胸片、头颅CT及脑电图正常。入院当天脑脊液 (CSF)常规示无色透明,蛋白 ,细胞总数17.8×106／L,WBC 数9.8×106／L,单核12％,多核88％,并于CSF中见鬼影细胞 (Mollaret细胞);CSF生化:蛋白66 mg％,糖7.53 mmol／L,氯 化物126.4 mEq／L。次日复查CSF常规:蛋白 ,细胞总数 0.68×106／L,WBC数为0.48×106／L,单核0.24,多核0.76;生化 提示蛋白仍偏高,糖、氯化物均正常。CSF墨汁染色未找到隐 球菌。CSF及血培养无菌生长。经用抗炎、降颅压等对症、支持 治疗,痊愈出院。 讨论 Mollaret's脑膜炎是一种良性复发性无菌性脑膜     

小儿化脓性脑膜炎与听力障碍

本文采用听觉脑干诱发反应测试技术(BAEP)对住院的化脑患儿定期检测听力共15例50耳次,发现有11例在化脑病程中听力受损(入院初),出院时(化脑痊愈时)4例恢复正常,7例仍有听力障碍,故以本文指出化脑所致之听力障碍作为后天性耳聋的主要原因之一,应引起大家关注。     

脑脊液改变不典型的化脓性脑膜炎

化脓性脑膜炎脑脊液可呈不典型改变，表现为脑脊液外观，生化，细胞数正常而细菌培养阳性，细胞数不多或分类以淋以淋巴细胞为主。多见于感染早期，婴幼儿或不规则治疗的病人。应提高警惕，以免误诊。     

炭疽杆菌性脑膜炎1例

患儿 ,女 ,1ａ ,因反复发热 5ｄ、抽搐 3次入院。入院前 5ｄ发热 ,体温 38.8℃ ,并有抽搐 ,表现为两眼上翻、凝视 ,右侧肢体抖动 ,数分种后自行缓解 ,精神稍差。入院当天再次出现类似发作 ,转我院。患儿邻居为皮革加工作坊。查体 :体温 37.1℃ ,神清 ,精神可 ,全身皮肤无皮疹、黑焦痂 ,心肺腹未见异常。颈无抵抗 ,生理反射正常 ,病理反射未引出。实验室检查血细胞 7.7× 10 9/Ｌ ,腰穿无色微混脑脊液 ,有纤维状凝块 ,细胞数 110× 10 6/Ｌ ,多核 0 .89,单核 0 .11,抗酸及墨汁染色阴性 ,革兰染色见革兰阳性粗大杆菌 ,竹节状短链排列 ,培养有…     

新型隐球菌性脑膜炎38例

目的 分析隐球菌性脑膜炎误诊的原因。探讨早期诊断方法。方法 采用回顾性方法对38例新型隐球菌性脑膜炎临床进行分析。并对其中25例误诊者原因进行探讨。结果 38例隐球菌性脑膜炎有25例误诊，结论 隐球菌性脑膜炎早期易误诊。多次脑脊液离心涂片墨汁染色镜检是防止漏诊，误诊的关键。     

132例新生儿化脓性脑膜炎脑脊液分析

目的 探讨新生儿化脓性脑膜炎临床症状、脑脊液常规之间的关系及对预后的影响.方法 选取化脓性脑膜炎新生儿132例作为研究对象,根据脑脊液白细胞计数增高程度的不同,对比脑脊液蛋白和葡萄糖的定量,以及治疗后脑脊液细胞计数恢复正常的天数.结果 随着脑脊液白细胞计数的增高,脑脊液蛋白定量及白细胞计数恢复正常的天数差异有统计学意义(P＜0.05).结论 提高穿刺率有助于早期发现新生儿化脓性脑膜炎,脑脊液中蛋白定量对化脓性脑膜炎危重程度及预后的判定有一定意义,脑脊液白细胞计数增高的程度对疗程有影响.     

流感嗜血杆菌致小儿下呼吸道感染 216例分析

目的 了解流感嗜血杆菌致小儿下呼吸道感染的菌株表型和临床特征。方法 对2001年8月至2002年7月经细菌培养证实的216例流感嗜血杆菌下呼吸道感染患儿的临床特点进行分析,并用玻片凝集法进行菌株血清分型,纸片扩散法检测药敏试验。结果 216例流感嗜血杆菌下呼吸道感染儿中,不定型株引起者占62．0％（134株）,可分型株占38．0％（82株）;可分型株中d型73株（占89．0％）,c型株5株（占6．1％）,f型2株,a和b型株各1株,未分离到e型菌株。男性患儿中可分型株的分离率（43．0％,61／142）明显高于女性（28．4％,21／74）,x^2=4．39,P〈0．05。药敏结果显示83．5％的菌株对氨苄西林敏感,对头孢克罗、头孢噻肟、头孢曲松和克拉霉素的敏感率分别高达98.5％、99．5％、99．5％和91．7％。所有菌株均对氨苄西林／舒巴坦、阿莫西林／克拉维酸和亚胺培南敏感。结论 不定型和d型流感嗜血杆菌是小儿下呼吸道感染的常见病原菌,氨苄西林等β-内酰胺类抗生素仍是治疗该菌感染的有效药物。     

副流感嗜血杆菌肺炎18例临床分析

小儿肺炎是发展中国家严重威胁儿童生命和健康的疾病。尽早明确肺炎的病原菌是合理选用抗生素、降低病死率的唯一途径。在2001年4月至7月间，我科住院的肺炎患儿共175例，经痰培养分离，由副流感嗜血杆菌(Haemophilus parainfluenzae，PHI)引起的肺炎18例，现报告如下。     

Hearing impairment following therapy of Haemophilus influenzae meningitis.

From 97 children with bacteriologically confirmed Haemophilus influenzae meningitis, 39 were treated with chloramphenicol (before 1970) and 58 with ampicillin (since 1970). In 1977 all patients were followed up with history, clinical examination, and audiometry. Sensorineural hearing defect was found in 5 chloramphenicol patients and in 10 ampicillin patients. Of the 82 patients for whom treatment was begun within 48 h of onset of symptoms, only two showed hearing deficit, while 13 of the 15 patients in whom treatment was begun later suffered from hearing impairment. It appears that it is not the antibiotic, but the delay between onset of symptoms and start of therapy, that is decisive for the occurrence of inner ear impairment.     

Primary haemophilus influenzae pyomyositis in an infant: a case report

Promyositis is a term used to denote primary pyogenic infection of the skeletal muscle. Because striped muscle tissue is normally resistant to bacterial infection, pyomyositis is very rare. In tropical countries, pyomyositis accounts for about 4% of hospital surgical admission, but it is far less common in temperate climates. It is more common in adults and especially in men, but it can occur at any age. We would like to present an 8-month-old infant to make pediatricians aware of the possibility of pyomyositis in cases of a mass over muscle, or of children complaining of joint pain or muscle aches even in the infancy period.     

Haemophilus influenzae bacterial meningitis: residual risk; case report]

Bacterial meningitis due to Haemophilus influenzae has become a rare, albeit not exceptional occurrence since generalized vaccination against that pathogen was instated, concerning as well incapsulated b and non-b Haemophilus influenzae strains, as non-incapsulated strains. CASE REPORT: A 19-month-old fully immunized infant was referred to our hospital for bacterial meningitis. CSF analysis elicited biotype III, non-incapsulated Haemophilus influenzae. CONCLUSION: Generalizing Haemophilus influenzae preventive inoculation has revolutionized the epidemiology of bacterial meningitis; however, a residual risk exists, which deserves to be taken into account.     

Recurrent meningitis: a case report

A 25-month-old girl is described who experienced three successive attacks of purulent meningitis due to Proteus mirabilis. Third generation cephalosporins were employed as treatment. Crainal radiography and computed tomography revealed a malformation, in the form of an epidermoid cyst, in a central occipital position; small cerebellar abscesses were also present. The lesion was removed by surgery which led to a complete recovery.