Assuntos
Humanos , Pré-Escolar , Criança , Masculino , Infecções por Proteus/congênito , Infecções por Proteus/etiologia , Infecções por Proteus/fisiopatologia , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus/patogenicidade , Cromossomo X/fisiopatologia , Cromossomo X/ultraestrutura , Agamaglobulinemia/diagnóstico , Agamaglobulinemia/embriologia , Agamaglobulinemia/fisiopatologia , Escherichia coli/isolamento & purificação , Pneumonia/congênito , Pneumonia/etiologia , Pneumonia/fisiopatologiaRESUMO
A newborn infant with Proteus mirabilis meningitis developed multiple brain abscesses with diameters ranging from 2 to 4 cm. Intravenous antibiotic therapy alone without surgical intervention led to the complete resolution of this complication. The case supports that this may be an acceptable treatment of multiple brain abscesses in neonates. However, the clinical outcome was relatively poor, since a porencephalic cyst, hypodense areas in CT scan, and psychomotor retardation were found at one year of age.
Assuntos
Antibacterianos/uso terapêutico , Abscesso Encefálico/congênito , Infecções por Proteus/congênito , Abscesso Encefálico/tratamento farmacológico , Quimioterapia Combinada , Humanos , Recém-Nascido , Masculino , Infecções por Proteus/tratamento farmacológico , Proteus mirabilis/efeitos dos fármacos , Tomografia Computadorizada por Raios XRESUMO
A case of neonatal brain abscess was reported. This female infant was born by spontaneous vertex delivery at 38 weeks gestation, weighing 3.1 kg. There were no antenatal and perinatal complications. The Apgar's score was 8 points and her head was 32.8 cm in circumference. Fifty-six hours after birth, she had a clonic general convulsion for about 3 minutes. On the next morning, convulsion recurred, and she was transferred to our hospital. When admitted to the Pediatrics, she was exhausted and irritable. But after hospitalization, she improved without convulsions. CT scan, performed 7 days after birth, revealed large low density areas in both frontal lobes. Electroencephalography showed spike discharge at all leads. The head circumference gradually increased and subsequent CT scans revealed enlargement of the bifrontal low density areas. The first operation was done 28 days after birth. A large amount of yellowish grey pus was aspirated from both sides and the cavity was irrigated. Tobramycin was administered into the abscess cavity. Culture of the pus grew proteus mirabilis. The postoperative conditions were good. But two weeks later her head started to enlarge with the bulging fontanelle. CT scan revealed marked dilation of the ventricles and enlargement of the left frontal abscess. At 2 months of age, second operation was done. Left frontal abscess was punctured and serous pus was aspirated. Proteus mirabilis was cultured again from the pus. Tobramycin was administered into the cavity via the drainage tube every day for a week. As the content of the abscess cavity became clear, V-P shunt and cyst-peritoneal shunt were performed. After shunting procedure, the increase of head circumference stopped and the fontanelle became flat and soft.(ABSTRACT TRUNCATED AT 250 WORDS)