关键词: 脑膜炎, 脑膜脑炎, 年龄, 细菌, 儿童

Abstract:

Objective To analyze the clinical characteristics of bacterial meningitis/ meningoencephalitis in children aged 5 years and above. Methods The clinical data of hospitalized children with bacterial meningitis/meningoencephalitis in the department of neurology in the hospital were retrospectively analyzed. Results A total of 39 (7.8%) children, 28 males and 11 females, aged 5-15 years with bacterial meningitis/meningoencephalitis were enrolled. The etiology included: nasal infection in 11 cases (28.2%), ear infection in 5 cases (12.8%), trauma in 3 cases (7.7%), immunodeficiency disease in 3 cases (7.7%), facial cellulitis in 2 cases (5.1%), anatomical abnormalities (dermoid cysts) in 1 case (2.7%), central nervous system tumors (lymphoma) in 1 case (2.7%), and unknown causes in 13 cases (33.3%). Symptoms include fever, headache, vomiting, disturbance of consciousness, convulsions, paralysis, facial paralysis and convulsive persistence. Pathogens were found in cerebrospinal fluid of 15 children (38.5%), including Neisseria gonorrhoeae, Streptococcus pneumoniae, Pseudomonas aeruginosa, Ralstonia pipiensis, Micrococcus kristinae, Rosemonas, Staphylococcus aureus, Streptococcus intermedius, Streptococcus constellatus and Listeria monocytogenes. Among them, pathogens of 10 cases were found by second generation sequencing, and 6 cases were found by cerebrospinal fluid culture. There were 17 cases (43.6%) with abnormal magnetic resonance imaging of the skull. Complications or sequelae included: subdural effusion in 35 cases (89.7%), subdural pus in 6 cases (15.4%), cerebral hernia in 6 cases (15.4%), hydrocephalus in 3 cases (7.7%), speech impairment in 2 cases (5.1%), and death in 1 case (2.7%). Conclusions The etiology of bacterial meningitis/meningoencephalitis in children aged 5 years or older should be actively sought, such as intracranial endothelioid cysts, primary tumors of the central nervous system, cellulitis of the head and face, sinusitis, immunodeficiency diseases, and trauma.

Key words: meningitis, meningoencephalitis, age, bacteria, child