Pneumococcal Meningitis Complicated with Hemolytic Uremic Syndrome: Report of Two Cases

肺炎雙球菌腦膜炎併發溶血性尿毒症候群：二病例報告

黃富源(Fu-Yuan huang) ； 林達雄(Dar-Shong Lin)

《Acta Paediatrica Sinica》 39卷1期 (1998/02) Pp. 58-61

https://doi.org/10.7097/APS.199802.0058

摘要

溶血性尿毒症候群併發於肺炎雙球菌感染的案例在文獻上的報告是相當少見的。本文報告兩個嬰兒罹患肺炎雙球菌腦膜炎併發溶血性貧血、血小板低下、急性腎衰竭、及T-抗原活化。其中一病兒合併抽搐不止，雖經積極治療，仍告不治；另一病兒經治療後，完全康復無後遺症。本文建議對於肺炎雙球菌腦膜炎患者若合併急性溶血性貧血、血小板低下、急性腎衰竭時，應攷慮溶血性尿毒症候群的可能性，並可做紅血球表面T-抗原的測試。若能儘早確定溶血性尿毒症侯群的診斷，並給予適當的治療，將可增進其癒後。

關鍵字

溶血性尿毒症候群 ； T-抗原 ； 肺炎雙球菌腦膜炎

並列摘要

Hemolytic uremic syndrome (HUS) in associated with infections of neuraminidase-producing Streptococcus pnumoniae was rarely reported in the literature. We report two infants with proven peumococcal meningitis associated with anemia, thrombocytopenia, renal failure, and T-antigen activation characteristic of neuraminidase activity. This supports a common pathogenesis in HUS following infection of neuraminidase-producing strains of S. pneumoniae. One infant complicated with status epilepticus died, and the other infant survived without sequelae. We recommend that neuraminidase production should be considered in case of pneumococcal meningitis associated with anemia and thrombocytopenia without diffuse bleeding tendency. Early recognition of HUS associated S. pneumoniae neuraminidase production is vital. The use of compatible washed red blood cells, meticulous supportive care and appropriate use of dialysis will improve survival.

並列關鍵字

neuraminidase ； T-antigen ； hemolytic uremic syndrome ； pneumococcal meningitis