投稿分類 微生物

主委發表種類: 壁報

投稿標題(中): 新生兒頭顱血腫感染合併腦膜炎：兩病例報告及文獻回顧

投稿標題(英): Menigitis complicating infected cephalohematoma: two case reports and literature review

投稿摘要: Infected cephalohematoma associated with meningitis is rare in neonatal period but potentially life-threatening. In Taiwan, Chang et al. reported 3 of 28 infants with infected cephalohematoma to be associated with meningitis in a period of 25 years. A recent literature review reported 11 of 43 infants had infected cephalohematoma with concurrent meningitis. The causative bacteria are predominately gram negative rods, especially Escherichia coli. The overall mortality rate remains high and which is related to the delayed diagnosis of meningitis and lack of surgical drainage. Herein we report 2 cases with infected cephalohematoma associated with meningitis. The one is caused by Escherichia coli and the other by Klebsiella pneumoniae. With intravenous ceftriaxone therapy (3 weeks) and surgical drainage of the infected cephalohematoma, both are treated successfully without any sequela reported. The reported cases of infected cephalohematoma with concurrent meningitis in literature are also reviewed.
The adequate durations of antibiotic therapy have not yet been established. However, it is suggested that neonates with infected cephalohematoma and concurrent bacteremia, meningitis, and osteomyelitis, to receive antibiotic therapy for at least 2-3 weeks, 3-4 weeks, and 4-6 weeks, respectively. Surgical drainage plays an important role in the management of infected cephalohematoma and failure of treatment has been reported with antimicrobial therapy alone. Repeated needle aspiration is also found to be a safe and effective alternative procedure. Early diagnosis of the association of meningitis is important and leads to a good prognosis.

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