摘要
馬偕醫院小兒科近八年來共有新生兒腦膜炎144例，腦脊髓液細菌培養為陽性者有60例，佔53.1%，其中腸內細菌佔58.3%，以Pseudomonas，E. coli和Klebsiella為最多，非腸內細菌引起的佔41.7%。致病菌原與發病年齡無關，先行因素以早產和早期破水為最重要。症狀與徵候大多是非特異性的，以發燒，食慾不振和前和囪前門膨脹為最常見。死亡率為46.5%，早産兒的死亡率比足月産者高，神經學症狀之中，只有對外刺激之反應消失與死亡率有關。追蹤活存病例35例中，27例正常，8例有明顯的後遺症，包括智能不足，言語障礙，水腦症和小腦症。我們要強調的是，雖然使用強效抗生素治療，新生兒腦膜炎的死亡率仍很高，能夠早期診斷和治療是最重要的。
關鍵字
無資料並列摘要
We collected 114 cases of neonatal meningitis at Mackay Memorial Hospital from 1969 to 1976.Boys outnumbered girls in this series, 70 to 44. Thirty-five enteric and twenty-five non-enteric organisms were isolated from the cerebrospinal fluid. The most common causative agents, in order of frequency, were Pseudomonas aeruginosa, E. coli and Klebsiella. There were no correlation between infection with coliform organ-isms and early onset. Blood cultures were positive for the same organism isolated from the spinal fluid in 16 of 48 obtained. The most frequent predisposing factors were prematurity (birth weight＜2500gm) and premature rupture of membrane. Presenting symptoms and signs were variable and non-specific. The common ones were fever, poor feeding and bulging of the anterior fontanel. The case fatality rate was 46.5%.Low birth weight infants had a significantly higher mortality rate. The absence of general afferents correlated with mortality, however, there was no correlation between the mortality rate and other neurologic signs, such as convulsion, opisthotonos, absent Moro reflex and rigidity. Sequelae were present on follow up examinations in 8 of the 35 survivors. The most notable severe residual deficits included mental retardation, speech disturbance, hydrocephalus and microcephaly.
延伸閱讀
- 吳淑芬、張益從、蔡長海（1990）。新生兒細菌性腦膜炎。Acta Paediatrica Sinica，31(2)，110-115。https://www.airitilibrary.com/Article/Detail?DocID=00016578-199004-31-2-110-115-a
- 游彩香、張梅蘭、徐道昌（1981）。新生兒顏面神經麻痺：文獻回顧及病例報告。中華民國復健醫學會雜誌，(9)，34-34。https://www.airitilibrary.com/Article/Detail?DocID=10253009-198112-x-9-34-34-o2
- Hong, J. Y., Lee, C. Y., Tsai, W. Y., Hsu, C. Y., Huang, L. M., & Liu, C. C. (1987). 黃質菌新生兒腦膜炎－四病例報告－. Acta Paediatrica Sinica, 28(6), 470-475. https://www.airitilibrary.com/Article/Detail?DocID=00016578-198712-28-6-470-475-a
- (2008). Meningococcal Meningitis. Statistics Of Communicable Diseases and Surveillance Report Republic China, (), 100-102. https://doi.org/10.30170/SCDSRRC.200812.0026
- （2006）。Meningococcal Meningitis。傳染病統計暨監視年報，()，80-82。https://doi.org/10.7017/SCDSRRC.200611.0080