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目的探讨B群溶血性链球菌(GBS)性脑膜炎的临床特点。方法选取2009—2012年广东省妇幼保健院新生儿重症监护病房收治的GBS脑膜炎病例,回顾性分析其围生期因素、临床表现、辅助检查、治疗和预后。结果研究期间共收治8例GBS脑膜炎患儿,发病日龄均>7天,主要表现为发热、抽搐、反应差,实验室检查炎症指标血白细胞(WBC)<4×109/L或>20×109/L 6例,超敏C反应蛋白(Hs-CRP)、降钙素原(PCT)等均不同程度增高,血小板变化不大,脑脊液呈典型化脓性脑膜炎改变,脑脊液培养GBS阳性8例,血培养GBS阳性4例,头颅CT证实脑积水4例。结论 GBS脑膜炎多为迟发性感染,临床表现与其他病原菌脑膜炎相似,脑脊液WBC明显增高,易复发,建议应用抗生素至少3周以上。
Objective To investigate the clinical features of group B hemolytic streptococcus (GBS) meningitis. Methods The cases of GBS meningitis admitted to neonatal intensive care unit in Guangdong MCH hospital from 2009 to 2012 were selected and their perinatal factors, clinical manifestations, auxiliary examination, treatment and prognosis were retrospectively analyzed. Results A total of 8 children with GBS meningitis were admitted during the study period. The onset days were> 7 days. The main symptoms were fever, convulsions and poor response. Laboratory tests showed that white blood cells (WBC) <4 × 109 / L or> 20 × 109 / L in 6 cases, Hs-CRP, procalcitonin (PCT) were increased to varying degrees, little change in platelets, cerebrospinal fluid was typical purulent meningitis, cerebrospinal fluid culture GBS-positive 8 Cases, blood culture GBS positive in 4 cases, cranial CT confirmed hydrocephalus in 4 cases. Conclusions GBS meningitis is mostly delayed infection. The clinical manifestations are similar to those of other pathogenic meningitis. The cerebrospinal fluid WBC is obviously increased and easy to relapse. It is recommended to use antibiotics for at least 3 weeks.