Objective To investigate the clinical characteristics of fatal cases of neonatal puru-lent meningitis(NPM)to raise awareness of the risk of death from this disease.Methods Retrospec-tive data was collected from 20 cases of NPM mortality in the Department of Neonatology at Hunan Childrens Hospital from June 2019 to June 2023.Clinical manifestations,test results,pathogeny and imaging features were analyzed.The differences in clinical characteristics of NPM in neonates were compared based on the age of onset and gestational age of the children.Results During the study pe-riod,653 NPM cases were admitted,among which,there were 20 cases with fatal outcomes(3.1％).Blood infection indicators such as leukocytes,C-reactive protein(CRP),procalcitonin(PCT),plate-lets,cerebrospinal fluid(CSF),leukocyte count,glucose and protein were significantly abnormal.A-mong them,14 cases were positive in blood culture and 10 cases were positive in CSF culture,with the main pathogens being group B Streptococcus(GBS)and Escherichia coli(E-coli).Among 15 cases,who underwent comprehensive cranial MRI+enhancement+DWI,all showed meningeal enhance-ment and cerebral edema,and 5 cases had brain herniation.All 20 cases underwent comprehensive mo-nitoring with Amplitude-Integrated Electroencephalography(aEEG),with 15 cases showing severe abnormalities.Leukocyte number in CSF in the early-onset group was higher than that in the late-on-set group,and the onset age in the premature group was older than that in the full-term group.Con-clusion NPM with GBS and E.coli as pathogens has a high risk of death,requiring early identifica-tion,prompt use of effective antibiotics and efforts to avoid adverse outcomes.It is also important to actively improve imaging and aEEG examinations to assess prognosis.
关键词
新生儿/化脓性脑膜炎/死亡/无乳链球菌/大肠埃希菌
Key words
newborns/purulent meningitis/death/group B Streptococcus/Escherichia coli
维普
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