早产儿微小脲原体脑膜炎并发脑积水1例  

Ureaplasma parvum meningitis complicated with hydrocephalus in premature infants:A case report and literature review

作　　者：冯梦婷 纪琼[1] 王宝英[1] 徐巍[1] FENG Meng-ting;JI Qiong;WANG Bao-ying(Department of Neonatology,First Hospital of Jilin University,Changchun 130012,China)

机构地区：[1]吉林大学第一医院新生儿科,吉林长春130012

出　　处：《中国实用儿科杂志》2024年第5期395-399,共5页Chinese Journal of Practical Pediatrics

摘　　要：探讨早产儿微小脲原体脑膜炎的临床特征、实验室检查及治疗措施。回顾性分析2022年2月吉林大学第一医院新生儿科收治的1例因微小脲原体感染导致脑积水病例的临床资料和诊治过程,并复习相关文献。患儿为27周早产儿,生后呼吸困难伴感染表现及出血倾向,早期即有颅内出血及脑脊液常规生化改变,血及脑脊液培养均阴性。抗生素治疗28d脑脊液常规生化无好转,并出现脑室扩张、脑积水,遂转入我院。入院后予Ommaya囊植入并每日引流脑脊液。行脑脊液宏基因组二代测序确诊微小脲原体脑膜炎,静脉应用阿奇霉素治疗21 d。脑积水好转,脑脊液常规生化恢复正常。出院后仍需每日放脑脊液。于生后6个月行侧脑室腹腔分流术。现随访至生后12个月,脑室大小正常,智力及运动发育正常。To explore the clinical features,laboratory examination and treatment of neonatal ureaplasma parvum meningitis.The clinical data and laboratory and diagnosis and treatment process of one case of hydrocephalus caused by ureaplasma parvum infection were retrospectively analyzed,and the relevant literature was reviewed.The female baby with 27 weeks of gestational age.She had dyspnea after birth,accompanied by signs of infection and bleeding tendency.Intracranial hemorrhage and cerebrospinal fluid analysis abnormalities were found in early postnatal period.Both blood and cerebrospinal fluid cultures were negative.The cerebrospinal fluid finding did not improve after 28d of antibiotic treatment,and the ventricular dilatation and hydrocephalus appeared,so the baby was transferred to our hospital.After admission,the Ommaya reservoir was implanted and the cerebrospinal fluid was drained daily.Cerebrospinal fluid metagenomic next-generation sequencing was performed to confirm the diagnosis of ureaplasma parvum meningitis,and intravenous treatment with azithromycin was performed for 21 days.Hydrocephalus was improved and cerebrospinal fluid finding returned to normal.Cerebrospinal fluid continued to be drained daily after discharge.Lateral ventriculoperitoneal shunt was performed at 6 months after birth.The patient was followed up to 12 months after birth,and the child has normal ventricular size and normal mental and motor development.

关 键 词：脲原体脑膜炎 早产儿 阿奇霉素 OMMAYA囊 宏基因组二代测序 

分 类 号：R72[医药卫生—儿科]