新生儿支原体脑炎1例

A case of neonatal mycoplasma encephalitis

本文报道了1例新生儿支原体脑炎。患儿因“皮肤黄染3天”入院,病程中有发热,入院后仍持续发热22天,热峰高达39℃,脑脊液检查显示白细胞计数升高、蛋白水平明显升高及葡萄糖水平显著降低,按照新生儿细菌性脑膜炎治疗后效果不佳,遂取脑脊液行宏基因组测序,第22天明确诊断为解脲支原体(Ureaplasma urealyticum,UU)感染。新生儿支原体感染以解脲支原体为主,感染主要来自母体宫内感染的垂直传播。支原体脑炎的临床表现及脑脊液改变均与新生儿细菌性脑膜炎类似,因此临床医师应重视病原学诊断,治疗宜选用大环内酯类药物。

A case of mycoplasma encephalitis in newborn was reported.Sick children was admitted to hospital due to“yellow skin for 3 days”.Fever was observed during the course of illness,and the fever sustained for 22 days with the highest temperature of 39℃after admission to the hospital.The examination of cerebrospinal fluid showed that the white blood cell count and the protein quatification level were obviously increased,and yet the glucose level was obviously decreased.Because of the poor effect from neonatal bacterial meningitis treatment,cerebrospinal fluid was taken for high-throughput gene detection of infectious pathogens,and Ureaplasma urealyticum was detected.Therefore,the patient was diagnosed as U.urealyticum infection.U.urealyticum is the main pathogen of neonatal mycoplasma infection,and the infection was mainly from the vertical transmission of intrauterine infection.The clinical manifestations and spinal fluid changes of mycoplasma encephalitis are pretty similar to those of neonatal bacterial meningitis.The Clinicians should pay attention to the etiological diagnosis,and macrolides can be selected for treatment.