Clinical features and subdural lesions in childhood onset Haemophilus influenzae meningitis

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概要

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• It becomes difficult to treat the onset of childhood Haemophilus influenza type b( Hib) meningitis due tothe appearance of b-lactamase negative ampicilin resistance( BLNAR). We investigated the clinical featuresof Hib meningitis with subdural lesions. From January 2000 to December 2006, we experienced 8 patientswith Hib meningitis. All patients were not inoculated with Hib vaccine. Five of them were onset under 1year old. Rapid latex diagnoses were made in 5 patients, among whom 4 patients showed Hib positive. Thegenotypes were determined in 4 patients with BLNAR. Combined with cefotaxime sodium (CTX) and ampicillin(ABPC) were used in 3 patients for the initial antibiotics, panipenem/betamipron( PAPM/BP) in 2,meropenem hydrate( MEPM) in 1, MEPM + ceftriaxone sodium( CTRX) in 1, and concomitant use of dexamethasonein 7 paitents. MRI showed subdural hygroma in 4 patients and subdural abscess in 4 patients.Subdural lesions appeared on Day 1 to Day 18 from the onset. Three patients with subdural abscess haveperformed subdural taps, and 2of them with difficulties after subdural taps were necessary to do oral administrationof chloramphenicol( CP).In our report, all of the patients developed subdural lesions. The development of subdural lesions cannotbe avoided with only the conventional antibiotics and dexamethasone therapy. Our cases suggested earliersubdural taps with oral administration of CP might be to improve both the general condition and control thesubdural lesions with Hib meningitis. Moreover, we should pay attention to the preventive vaccination ofHib.

• 2010-10-25

著者

• Osamu Arisaka1

  Department of 1) Pediatrics, 2) Radiology, 3) Critical care & medicine and 4) Ophthalmology,Dokkyo M

• George Imataka1

  Department of Pediatrics1 and Clinical Laboratory Medicine2, Dokkyo Medical University

• Atsushi Yoshida2

  Department of Pediatrics1 and Clinical Laboratory Medicine2, Dokkyo Medical University

• Keiko Tsukada1

  Department of Pediatrics1 and Clinical Laboratory Medicine2, Dokkyo Medical University

• Satomi Koyama1

  Department of Pediatrics1 and Clinical Laboratory Medicine2, Dokkyo Medical University

• Naoto Shimura1

  Department of Pediatrics1 and Clinical Laboratory Medicine2, Dokkyo Medical University

• Keitaro Fukushima1

  Department of Pediatrics1 and Clinical Laboratory Medicine2, Dokkyo Medical University

• Keiko Tsukada1

  Department Of Pediatrics1 And Clinical Laboratory Medicine2 Dokkyo Medical University

• George Imataka1

  Department Of Pediatrics1 And Clinical Laboratory Medicine2 Dokkyo Medical University

• Naoto Shimura1

  Department Of Pediatrics1 And Clinical Laboratory Medicine2 Dokkyo Medical University

• Satomi Koyama1

  Department Of Pediatrics1 And Clinical Laboratory Medicine2 Dokkyo Medical University

• Osamu Arisaka1

  Department Of Pediatrics1 And Clinical Laboratory Medicine2 Dokkyo Medical University

• Atsushi Yoshida2

  Department Of Pediatrics1 And Clinical Laboratory Medicine2 Dokkyo Medical University

• Keitaro Fukushima1

  Department Of Pediatrics1 And Clinical Laboratory Medicine2 Dokkyo Medical University

• Shimura Naoto

  Department Of Paediatrics Urayasu-ichikawa Shimin Hospital

• Koyama Satomi

  Department Of Pediatrics Dokkyo University School Of Medicine

• Fukushima Keitaro

  Department Of Pediatrics Dokkyo Medical University

• Yoshida Atsushi

  Department Of Breast Surgery St. Luke's International Hospital

• Arisaka Osamu

  Department of Pediatrics ,Dokkyo Medical University School of Medicine

• Tsukada Keiko

  Department of Pediatrics, Dokkyo Medical University School of Medicine

• Imataka George

  Department of Pediatrics, Dokkyo Medical University

• Imataka George

  Department of Pediatrics ,Dokkyo Medical University School of Medicine

• Koyama Satomi

  Department of Pediatrics, Dokkyo Medical University

• Tsukada Keiko

  Department of Pediatrics, Dokkyo Medical University

• Yoshida Atsushi

  Department of Clinical Laboratory Medicine, Dokkyo Medical University

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