BACKGROUND Streptococcus gallolyticus subspecies pasteurianus(SGSP)is a rare pathogen responsible for infant sepsis and meningitis and is potentially overlooked because it is not included in routine group B streptococ...BACKGROUND Streptococcus gallolyticus subspecies pasteurianus(SGSP)is a rare pathogen responsible for infant sepsis and meningitis and is potentially overlooked because it is not included in routine group B streptococcal screenings.Hence,we present a case of SGSP-induced infant meningitis and sepsis,accompanied by bronchopneumonia induced by multidrug-resistant Staphylococcus aureus(MRSA),providing insights into the identification,management,and prognosis of this bacterial infection.CASE SUMMARY A 45-day-old female infant presented with two episodes of high fever(maximum temperature:39.5°C)and two generalized grand mal seizure episodes that lasted over ten seconds and self-resolved without concomitant symptoms.Postadmission,the patient’s C-reactive protein level was 40.73 mg/L,white blood cell count was 13.42×10^(9)/L,neutrophil ratio was 78.4%,procalcitonin level was 7.89μg/L,cerebrospinal fluid(CSF)white cell count was 36×10^(6)/L,multinucleated cell ratio was 95.2%,and protein concentration was 0.41 g/L.Blood and CSF culture revealed that the pathogen was SGSP.The bacterium was sensitive to ampicillin,furazolidone,penicillin,lincomycin,moxifloxacin,rifampicin,vancomycin,and levofloxacin but resistant to clindamycin and tetracycline.Sputum culture revealed the presence of MRSA,which was sensitive to vancomycin.The patient was diagnosed with meningitis and sepsis caused by SGSP,accompanied by bronchopneumonia induced by MRSA.Ceftriaxone(100 mg/kg/d)combined with vancomycin(10 mg/kg/dose,q6h)was given as an anti-infective treatment postadmission.After 12 days of treatment,the infant was discharged from the hospital with normal CSF,blood culture,and routine blood test results,and no complications,such as subdural effusion,were observed on cranial computed tomography.No growth retardation or neurological sequelae occurred during follow-up.CONCLUSION SGPSP-induced infant bacterial meningitis and sepsis should be treated with prompt blood and CSF cultures,and a sensitive antibiotic therapy to ensure a favorable prognosis.展开更多
目的探讨甲泼尼龙琥珀酸钠联合硫酸镁治疗小儿喘息性支气管肺炎的疗效对患者炎症指标的影响。方法选取2021年10月至2022年10月东台市人民医院收治的130例喘息性支气管肺炎患儿作为研究对象,按照随机数字表法分为常规组与观察组,每组65...目的探讨甲泼尼龙琥珀酸钠联合硫酸镁治疗小儿喘息性支气管肺炎的疗效对患者炎症指标的影响。方法选取2021年10月至2022年10月东台市人民医院收治的130例喘息性支气管肺炎患儿作为研究对象,按照随机数字表法分为常规组与观察组,每组65例。常规组给予甲泼尼龙琥珀酸钠治疗,观察组给予甲泼尼龙琥珀酸钠联合硫酸镁治疗,比较两组临床疗效、炎症指标[超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、中性粒细胞百分比(percentage of neutrophils,NEUT%)、降钙素原(procalcitonin,PCT)]及不良反应发生情况。结果观察组治疗总有效率高于常规组,差异有统计学意义(P<0.05)。观察组咳嗽、气喘、肺啰音、气促症状消失时间及肺部炎症消失时间、住院时间均短于常规组,差异有统计学意义(P<0.05)。治疗后,两组hs-CRP、NEUT%及PCT均低于治疗前,且观察组低于常规组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论甲泼尼龙琥珀酸钠联合硫酸镁治疗喘息性支气管肺炎患儿疗效显著,可缩短症状改善时间,改善炎症反应程度,值得临床推广应用。展开更多
基金Supported by the Scientific Research Project from the Health Commission of Mianyang City,No.201903.
文摘BACKGROUND Streptococcus gallolyticus subspecies pasteurianus(SGSP)is a rare pathogen responsible for infant sepsis and meningitis and is potentially overlooked because it is not included in routine group B streptococcal screenings.Hence,we present a case of SGSP-induced infant meningitis and sepsis,accompanied by bronchopneumonia induced by multidrug-resistant Staphylococcus aureus(MRSA),providing insights into the identification,management,and prognosis of this bacterial infection.CASE SUMMARY A 45-day-old female infant presented with two episodes of high fever(maximum temperature:39.5°C)and two generalized grand mal seizure episodes that lasted over ten seconds and self-resolved without concomitant symptoms.Postadmission,the patient’s C-reactive protein level was 40.73 mg/L,white blood cell count was 13.42×10^(9)/L,neutrophil ratio was 78.4%,procalcitonin level was 7.89μg/L,cerebrospinal fluid(CSF)white cell count was 36×10^(6)/L,multinucleated cell ratio was 95.2%,and protein concentration was 0.41 g/L.Blood and CSF culture revealed that the pathogen was SGSP.The bacterium was sensitive to ampicillin,furazolidone,penicillin,lincomycin,moxifloxacin,rifampicin,vancomycin,and levofloxacin but resistant to clindamycin and tetracycline.Sputum culture revealed the presence of MRSA,which was sensitive to vancomycin.The patient was diagnosed with meningitis and sepsis caused by SGSP,accompanied by bronchopneumonia induced by MRSA.Ceftriaxone(100 mg/kg/d)combined with vancomycin(10 mg/kg/dose,q6h)was given as an anti-infective treatment postadmission.After 12 days of treatment,the infant was discharged from the hospital with normal CSF,blood culture,and routine blood test results,and no complications,such as subdural effusion,were observed on cranial computed tomography.No growth retardation or neurological sequelae occurred during follow-up.CONCLUSION SGPSP-induced infant bacterial meningitis and sepsis should be treated with prompt blood and CSF cultures,and a sensitive antibiotic therapy to ensure a favorable prognosis.
文摘目的探讨甲泼尼龙琥珀酸钠联合硫酸镁治疗小儿喘息性支气管肺炎的疗效对患者炎症指标的影响。方法选取2021年10月至2022年10月东台市人民医院收治的130例喘息性支气管肺炎患儿作为研究对象,按照随机数字表法分为常规组与观察组,每组65例。常规组给予甲泼尼龙琥珀酸钠治疗,观察组给予甲泼尼龙琥珀酸钠联合硫酸镁治疗,比较两组临床疗效、炎症指标[超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、中性粒细胞百分比(percentage of neutrophils,NEUT%)、降钙素原(procalcitonin,PCT)]及不良反应发生情况。结果观察组治疗总有效率高于常规组,差异有统计学意义(P<0.05)。观察组咳嗽、气喘、肺啰音、气促症状消失时间及肺部炎症消失时间、住院时间均短于常规组,差异有统计学意义(P<0.05)。治疗后,两组hs-CRP、NEUT%及PCT均低于治疗前,且观察组低于常规组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论甲泼尼龙琥珀酸钠联合硫酸镁治疗喘息性支气管肺炎患儿疗效显著,可缩短症状改善时间,改善炎症反应程度,值得临床推广应用。
