在儿童的腰椎穿刺后检查传染性并发症
Talal B Seddik1, Julianne E Burns1, Sharon F Chen1
1Division of Pediatrics Infectious Diseases, Stanford Medicine, Stanford University, Palo Alto, CA, USA.
Clinical pediatrics
|November 18, 2024
概括
在儿童的腰部穿刺 (LP) 后的传染性并发症很少见,但很严重. 儿科医生应考虑重复LP,如果临床变化表明初始手术后脑膜炎.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 神经学 神经学
背景情况:
- 儿科患者的腰部穿刺 (LP) 的传染性并发症没有得到充分的记录.
- 及时诊断和管理中枢神经系统感染对儿童至关重要.
研究的目的:
- 调查儿童LP后感染并发症的发病率和临床特征.
- 提高儿科医生对LP后潜在的阳性感染的认识.
主要方法:
- 在3年的时间里,对被诊断患有细菌性脑膜炎,脊髓内或脊椎骨质炎的儿童的医疗记录进行了回顾性审查.
- 传染病专家使用利克尔特尺度评估了已确定的病例中阳性因果关系的可能性.
主要成果:
- 确定了五例病例:4例为细菌性脑膜炎,1例为脊椎骨质炎.
- 在细菌性脑膜炎病例中,重复的LP证实了诊断,症状在最初的LP后8-10小时出现.
- 专家对阳性因果关系的评估显示了可变的确定性.
结论:
- 虽然很少见,但在儿科腰部穿刺后可能会发生传染性并发症.
- 儿科医生应在LP后保持高的脑膜炎怀疑指数,并在临床恶化发生时考虑重复LP.
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