儿童麻疹孪生球菌脑膜炎诊治分析

Analysis of the diagnosis and treatment of children Gemella mobillorum meningitis

目的 提高对儿童麻疹孪生球菌脑膜炎的认识.方法 对3例麻疹孪生球菌脑膜炎患儿的临床资料进行回顾性分析并复习相关文献.结果 3例患儿均以发热、呕吐起病,1例伴有抽搐.辅助检查示血象增高,中性粒占优势,血沉、C-反应蛋白（CRP）、降钙素原（PCT）增高,免疫功能低下.1例有先天性耳聋以及脑脊液鼻漏,2例有既往颅内感染病史.2例脑脊液培养示麻疹孪生球菌生长,1例血液培养示麻疹孪生球菌生长.给予美罗培南（或者头孢类抗生素）联合利福霉素治疗后,痊愈.结论 儿童麻疹孪生球菌脑膜炎易发生于免疫低下和血脑屏障不完整的的儿童,预后相对较好.

Objective To improve the awareness of the Gemella mobillorum meningitis in children.Methods The clinical data of 3 cases of children Gemella mobillorum meningitis were retrospectively analyzed and the related literatures were reviewed.Results All the onset of the 3 patients were fever and vomiting,1 patient with convulsions.The auxiliary examination of all the 3 patients showed that the white blood cell count increased,and the neutrophil increased prominently.ESR,CRP,PCT increased while the immunologic function decreased.One patient had congenital deafness,and cerebrospinal fluid rhinorrhea.In 2 patients,the cerebrospinal fluid culture showed that the Gemella mobillorum growth.In 1 patient,the blood cultures showed that the Gemella mobillorum growth.After be given the united anti-infection treatment with rifamycin and meropenem （or cephalosporins）,all the 3 patient were healed.Conclusions The Gemella mobillorum meningitis in children prone to occure in the condition of the immunosuppression and incomplete blood-brain barrier.And the prognosis is relatively good,compared with the adult.