多発性脳膿瘍を合併したProteus mirabilis髄膜炎の新生児例
日齢28男児．日齢4に発熱，活気不良で発症しProteus mirabilisによる細菌性髄膜炎と診断，抗菌薬治療を行った．頭部MRIで多発性脳膿瘍を認め増悪傾向にあるため，日齢30に脳室と交通していない3つの膿瘍に対して穿頭膿瘍ドレナージ術を行った．脳膿瘍は収束したが水頭症を合併し，脳室腹腔短絡術を要した．2歳1か月時点で中等度の発達の遅れを認める．PM髄膜炎は脳膿瘍を合併し予後が極めて不良であるため，臨床症状や画像評価に基づく適切な外科的治療を早期に行うことが重要である．...
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| Published in | 小児の脳神経 Vol. 47; no. 4; pp. 389 - 394 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本小児神経外科学会
2022
日本小児神経外科学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0387-8023 2435-824X |
| DOI | 10.34544/jspn.47.4_389 |
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| Abstract | 日齢28男児．日齢4に発熱，活気不良で発症しProteus mirabilisによる細菌性髄膜炎と診断，抗菌薬治療を行った．頭部MRIで多発性脳膿瘍を認め増悪傾向にあるため，日齢30に脳室と交通していない3つの膿瘍に対して穿頭膿瘍ドレナージ術を行った．脳膿瘍は収束したが水頭症を合併し，脳室腹腔短絡術を要した．2歳1か月時点で中等度の発達の遅れを認める．PM髄膜炎は脳膿瘍を合併し予後が極めて不良であるため，臨床症状や画像評価に基づく適切な外科的治療を早期に行うことが重要である． |
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| AbstractList | 日齢28男児．日齢4に発熱，活気不良で発症しProteus mirabilisによる細菌性髄膜炎と診断，抗菌薬治療を行った．頭部MRIで多発性脳膿瘍を認め増悪傾向にあるため，日齢30に脳室と交通していない3つの膿瘍に対して穿頭膿瘍ドレナージ術を行った．脳膿瘍は収束したが水頭症を合併し，脳室腹腔短絡術を要した．2歳1か月時点で中等度の発達の遅れを認める．PM髄膜炎は脳膿瘍を合併し予後が極めて不良であるため，臨床症状や画像評価に基づく適切な外科的治療を早期に行うことが重要である． 「要旨」日齢28男児. 日齢4に発熱, 活気不良で発症しProteus mirabilisによる細菌性髄膜炎と診断, 抗菌薬治療を行った. 頭部MRIで多発性脳膿瘍を認め増悪傾向にあるため, 日齢30に脳室と交通していない3つの膿瘍に対して穿頭膿瘍ドレナージ術を行った. 脳膿瘍は収束したが水頭症を合併し, 脳室腹腔短絡術を要した. 2歳1か月時点で中等度の発達の遅れを認める. PM髄膜炎は脳膿瘍を合併し予後が極めて不良であるため, 臨床症状や画像評価に基づく適切な外科的治療を早期に行うことが重要である. |
| Author | 大西, 聡 松浦, 想 宇津木, 玲奈 前野, 和重 起塚, 庸 齋藤, 多恵子 石森, 真吾 藪本, 佳奈子 原田, 敦子 有田, 英之 |
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| References | [14] Spennato P, Aliberti F, Colaleo F, Mirone G, Di Martino G, Cinalli G: Endoscopic ultrasonic aspiration of brain abscess. Childs Nerv Syst 34: 1579-1582, 2018. [1] Arlotti M, Grossi P, Pea F, Tomei G, Vullo V, De Rosa FG, Di Perri G, Nicastri E, Lauria FN, Carosi G, et al: Consensus document on controversial issues for the treatment of infections of the central nervous system: bacterial brain abscesses. Int J Infect Dis 14: S79-S92, 2010. [10] Raffaldi I, Garazzino S, Castelli GG, Lipreri R, Lancella L, Esposito S, Giannini AM, Montagnani C, Marseglia GL, Pignata C, et al: Brain abscesses in children: an Italian multicentre study. Epidemiol Infect 145: 2848-2855, 2017. [11] Saez-Llorens X, Umana M, Odio C, Mccracken G, Nelson J: Brain abscess in children. Semin Pediatr Infect Dis 14: 108-114, 2003. [5] Hoffman HJ, Hendrick EB, Hiscox JL: Cerebral abscesses in early infancy. J Neurosurg 33: 172-177, 1970. [2] Auvichayapat N, Auvichayapat P, Aungwarawong S: Brain abscess in infants and children: a retrospective study of 107 patients in Northeast Thailand. J Med Assoc Thai 90: 1601-1607, 2007. [13] Smith ML, Mellor D: Proteus mirabilis meningitis and cerebral abscess in the newborn period. Arch Dis Child 55: 308-310, 1980. [6] Juyal D, Rathaur VK, Sharma N: Neonatal meningoventriculitis due to proteus mirabilis - a case report. J Clin Diagn Res 7: 369-370, 2013. [3] Chung MH, Kim GJ, Han A, Lee JY: Case report of neonatal Proteus mirabilis meningitis and brain abscess with negative initial image finding: consideration of serial imaging studies. Neonatal Med 24: 187-191, 2017. [8] Ouchenir L, Renaud C, Khan S, Bitnun A, Boisvert AA, McDonald J, Bowes J, Brophy J, Barton M, Ting J, et al: The epidemiology, management, and outcomes of bacterial meningitis in infants. Pediatrics 140: e20170476, 2017. [7] Lee CG, Kang SH, Kim YJ, Shin HJ, Choi HS, Lee JH, Lee MH: Brain abscess in Korean children: a 15-year single center study. Korean J Pediatr 53: 648-652, 2010. [12] Shortland-Webb WR: Proteus and coliform meningoencephalitis in neonates. J Clin Pathol 21: 422-431, 1968. [4] Erickson TA, Munoz FM, Troisi CL, Nolan MS, Hasbun R, Brown EL, Murray KO: The epidemiology of meningitis in infants under 90 days of age in a large pediatric hospital. Microorganisms 9: 526, 2021. [9] Phan H, Lehman D: Cerebral abscess complicating Proteus mirabilis meningitis in a newborn infant. J Child Neurol 27: 405-407, 2012. |
| References_xml | – reference: [4] Erickson TA, Munoz FM, Troisi CL, Nolan MS, Hasbun R, Brown EL, Murray KO: The epidemiology of meningitis in infants under 90 days of age in a large pediatric hospital. Microorganisms 9: 526, 2021. – reference: [8] Ouchenir L, Renaud C, Khan S, Bitnun A, Boisvert AA, McDonald J, Bowes J, Brophy J, Barton M, Ting J, et al: The epidemiology, management, and outcomes of bacterial meningitis in infants. Pediatrics 140: e20170476, 2017. – reference: [7] Lee CG, Kang SH, Kim YJ, Shin HJ, Choi HS, Lee JH, Lee MH: Brain abscess in Korean children: a 15-year single center study. Korean J Pediatr 53: 648-652, 2010. – reference: [6] Juyal D, Rathaur VK, Sharma N: Neonatal meningoventriculitis due to proteus mirabilis - a case report. J Clin Diagn Res 7: 369-370, 2013. – reference: [10] Raffaldi I, Garazzino S, Castelli GG, Lipreri R, Lancella L, Esposito S, Giannini AM, Montagnani C, Marseglia GL, Pignata C, et al: Brain abscesses in children: an Italian multicentre study. Epidemiol Infect 145: 2848-2855, 2017. – reference: [11] Saez-Llorens X, Umana M, Odio C, Mccracken G, Nelson J: Brain abscess in children. Semin Pediatr Infect Dis 14: 108-114, 2003. – reference: [13] Smith ML, Mellor D: Proteus mirabilis meningitis and cerebral abscess in the newborn period. Arch Dis Child 55: 308-310, 1980. – reference: [1] Arlotti M, Grossi P, Pea F, Tomei G, Vullo V, De Rosa FG, Di Perri G, Nicastri E, Lauria FN, Carosi G, et al: Consensus document on controversial issues for the treatment of infections of the central nervous system: bacterial brain abscesses. Int J Infect Dis 14: S79-S92, 2010. – reference: [14] Spennato P, Aliberti F, Colaleo F, Mirone G, Di Martino G, Cinalli G: Endoscopic ultrasonic aspiration of brain abscess. Childs Nerv Syst 34: 1579-1582, 2018. – reference: [3] Chung MH, Kim GJ, Han A, Lee JY: Case report of neonatal Proteus mirabilis meningitis and brain abscess with negative initial image finding: consideration of serial imaging studies. Neonatal Med 24: 187-191, 2017. – reference: [12] Shortland-Webb WR: Proteus and coliform meningoencephalitis in neonates. J Clin Pathol 21: 422-431, 1968. – reference: [2] Auvichayapat N, Auvichayapat P, Aungwarawong S: Brain abscess in infants and children: a retrospective study of 107 patients in Northeast Thailand. J Med Assoc Thai 90: 1601-1607, 2007. – reference: [5] Hoffman HJ, Hendrick EB, Hiscox JL: Cerebral abscesses in early infancy. J Neurosurg 33: 172-177, 1970. – reference: [9] Phan H, Lehman D: Cerebral abscess complicating Proteus mirabilis meningitis in a newborn infant. J Child Neurol 27: 405-407, 2012. |
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| Snippet | 日齢28男児．日齢4に発熱，活気不良で発症しProteus mirabilisによる細菌性髄膜炎と診断，抗菌薬治療を行った．頭部MRIで多発性脳膿瘍を認め増悪傾向にあるため，日齢30に... 「要旨」日齢28男児. 日齢4に発熱, 活気不良で発症しProteus mirabilisによる細菌性髄膜炎と診断, 抗菌薬治療を行った. 頭部MRIで多発性脳膿瘍を認め増悪傾向にあるため, 日... |
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| Title | 多発性脳膿瘍を合併したProteus mirabilis髄膜炎の新生児例 |
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