Escherichia coliによる髄膜炎,敗血症を合併した感染性頭血腫の1例(東京女子医科大学東医療センター小児科開局40周年記念論文集)

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Cephalohematoma is usually the result of a birth injury sustained by newborn infants. It is generally a benign condition that requires no treatment. Bacterial infection is a rare complication of cephalohematoma that is usually related to needle aspiration, sepsis or meningitis. Cephalohematoma infection may lead to osteomyelitis. The case is a 10-day-old female newborn. On day 10, she became febrile and the size of her cephalohematoma increased. Thus she was admitted to our hospital. On admission, the skin overlying the cephalohematoma was tense and red. Her white blood cell count was 16,900/μl, the C-reactive protein was 7.03 mg/dl. The cerebrospinal fluid (CSF) cell count was not increased. Escherichia coli grew from the CSF and the aspirated pus of the hematoma cultures. We administered antibiotics intravenously. The next day, the CSF cell count increased to 4048/3. We changed the antibiotic and increased the dose, but she continued to be febrile and the hematoma enlarged. We therefore performed a surgical incision and applied drainage for 3 days. Her temperature subsequently decreased. When we encounter a cephalohematoma that tends to enlarge, and is red and warm, we must consider infection, and a diagnostic tap should be performed immediately. Adequate incision and drainage with appropriate antibiotic administration are mandatory.
東京女子医科大学の論文
2007-05-31