Staphylococcus epidermidis meningitis in combination with acute disseminated encephalomyelitis A case report  

作　　者：Xin Chen Haijin Chen Zhiqin Liu Cailing Chen Fenping Luo Zhichun Feng 

机构地区：[1]Department of Pediatrics, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing 100710, China [2]Department of Nuclear Medicine, Beijing Military Region General Hospital, Beijing 100710, China

出　　处：《Neural Regeneration Research》2009年第11期843-845,共3页中国神经再生研究（英文版）

摘　　要：A nine-year-old girl with Staphylococcus epidermidis meningitis combined with acute disseminated encephalomyelitis （ADEM） was enrolled in the present study, and exhibited sustained fever and headache for 5 days and a single seizure episode. Meningeal irritation and disturbance of consciousness were apparent. Cerebrospinal fluid examination revealed increased protein level and pleocytosis. Cerebrospinal fluid culture demonstrated Staphylococcus epidermidis growth. The patient was treated with intravenous cefotaxime, intravenous dexamethasone, and decreasing intracranial pressure for 3 weeks. Seizures and fever symptoms improved, but disturbance of consciousness, muscle weakness, and bilateral limb paresis were significant. IgG index was elevated and oligoclonal bands were positive in the cerebrospinal fluid. Magnetic resonance imaging demonstrated high T2-weighted signals in subcortical white matter, which were consistent with ADEM. High-dose methylprednisolone for 3 days and a 6-day pulse therapy with immunoglobulins resulted in improved clinical symptoms and cerebrospinal fluid examination. The patient＇s temperature dropped to normal, and the headache disappeared. A Staphylococcus epidermidis infection associated with ADEM is uncommon in children. Results suggested that Staphylococcus epidermidis infection could be a pathogenic factor for ADEM, and ADEM is a complication of Staphylococcus epidermidis meningitis.A nine-year-old girl with Staphylococcus epidermidis meningitis combined with acute disseminated encephalomyelitis （ADEM） was enrolled in the present study, and exhibited sustained fever and headache for 5 days and a single seizure episode. Meningeal irritation and disturbance of consciousness were apparent. Cerebrospinal fluid examination revealed increased protein level and pleocytosis. Cerebrospinal fluid culture demonstrated Staphylococcus epidermidis growth. The patient was treated with intravenous cefotaxime, intravenous dexamethasone, and decreasing intracranial pressure for 3 weeks. Seizures and fever symptoms improved, but disturbance of consciousness, muscle weakness, and bilateral limb paresis were significant. IgG index was elevated and oligoclonal bands were positive in the cerebrospinal fluid. Magnetic resonance imaging demonstrated high T2-weighted signals in subcortical white matter, which were consistent with ADEM. High-dose methylprednisolone for 3 days and a 6-day pulse therapy with immunoglobulins resulted in improved clinical symptoms and cerebrospinal fluid examination. The patient＇s temperature dropped to normal, and the headache disappeared. A Staphylococcus epidermidis infection associated with ADEM is uncommon in children. Results suggested that Staphylococcus epidermidis infection could be a pathogenic factor for ADEM, and ADEM is a complication of Staphylococcus epidermidis meningitis.

关 键 词：acute disseminated encephalomyelitis Staphylococcus epidermidis infection CHILDREN 

分 类 号：S858.317.1[农业科学—临床兽医学] S858.31[农业科学—兽医学]