bacterialmeningitis(編輯修改稿)
2025-08-13 20:43 本頁(yè)面
【文章內(nèi)容簡(jiǎn)介】 ilus influenzae and pneumococal infection. ? Seizures is correlative with the inflammation of brain parenchyma, cerbral infarction and electrolyte disturbances. Clinical manifestation ? Clinical manifestation of CNS ? Conscious disturbance ? Drowsiness ? Clouding of consciousness ? Coma ? Psychiatric symptom ? Irritation ? Dysphoria ? dullness Clinical manifestation ? Clinical manifestation of CNS ? Meningeal irritation sign ? Neck stiffness ? Positive Kernig’s sign ? Positive Brudzinski’s sign Clinical manifestation ? Clinical manifestation of CNS ? Transient or permanent paralysis of cranial nerves and limbs may be noted. ? Deafness or disturbances in vestibular function are relatively mon. ? Involvement of the optic nerve, with blindness, is rare. ? Paralysis of the 6th cranial nerve, usually transient, is noted frequently early in the course. Clinical manifestation ? Symptom and signs of the infant under the age of 3 months ? In some children, particularly young infants under the age of 3 months, symptom and signs of meningeal inflammation may be minimal. ? Fever is generally present, but its absence or hypothermia in a infant with meningeal inflammation is mon. ? Only irritability, restlessness, dullness, vomiting, poor feeding, cyanosis, dyspnea, jaundice, seizures, shock and a may be noted. ? Bulging fontanel may be found, but there is not meningeal irritation sign. Complication ? Subdural effusion ? Subdural effusions occur in about 10%30% of children with bacterial meningitis. ? Subdural effusions appear to be more frequent in the children under the age of 1 year and in haemophilus influenzae and pneumococal infection. ? Clinical manifestations are enlargement in head circumference, bulging fontanel, cranial sutures diastasis and abnormal transillumination of the skull. ? Subdural effusions may be diagnosed by the examination of CT or MRI and subdural pricking. Complication ? Ependymitis ? Neonate or infant with meningitis ? Gramnegative bacterial infection ? Clinical manifestation ? Persistent hyperpyrexia, ? Frequent convulsion ? Acute respiratory failure ? Bulging fontanel ? Ventriculomegaly (CT) ? Cerebrospinal fluid by ventricular puncture ? WBC50 109/L ? Glucose? Protein Complication ? Cerebullar hyponatremia ? Syndrem of inappropriate secretion of antidiuretic hormone (SIADH) ? Hyponatremia ? Degrade of blood osmotic pressure ? Aggravated cerebral edema ? Frequent convulsion ? Aggravated conscious disturbance Complication ? Hydrocephalus ? Increased intracranial pressure ? Bulging fontanel ? Augmentation of head circumference ? Brain function disorder ? Other plication ? Deafness or blindness ? Epilepsy ? Paralysis ? Mental retardation ? Behavior disorder Laboratory Findings ? Peripheral hemogram ? Total WBC count ?20 109/L ～ 40 109/L WBC ?Decreased WBC count at severe infection
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