ABSTRACT
<p><b>OBJECTIVE</b>To study the clinical characteristics, antibiotics sensitivity and outcome of group B streptococcus (GBS) meningitis in neonates in order to provide the guide for early diagnosis and appropriate treatment.</p><p><b>METHOD</b>A retrospective review was performed and a total of 13 cases of neonatal purulent meningitis caused by GBS were identified in the Neonatal Intensive Care Unit of Yuying Children's Hospital of Wenzhou Medical University from January 1, 2005 to May 31, 2013. The clinical characteristics, antibiotics sensitivity test results and outcome were analyzed.</p><p><b>RESULT</b>Fever, poor feeding, seizure and lethargy were common clinical signs of neonatal purulent meningitis caused by GBS. Three cases of early onset GBS meningitis received prepartum antibiotics. All 13 cases had abnormal C-reactive protein (CRP) level, and 11 cases had increased CRP within hours after admission. Of the 13 patients, 7 were cured, 4 discharged with improvement, 2 patients died during hospitalization after being given up because of serious complication. The average length of stay for recovered patients was (47 ± 21)d. Acute complications mainly included hyponatremia (5 cases), intracranial hemorrhage (3 cases) , ventriculomegaly (3 cases) , subdural collection (2 cases) , hydrocephalus (2 cases), septic shock (2 cases), cerebral hernia (1 case), encephalomalacia (1 case). One preterm patient with early onset GBS meningitis died 1 month after hospital discharge. Among 7 survivors with 10-24 months follow-up, 3 were early onset GBS meningitis, 2 with normal results of neurologic examination, 1 with delayed motor development, 4 were late onset GBS meningitis, 1 with normal results of neurologic examination, 3 were neurologically impaired with manifestations including delayed motor development (2 cases) and seizures (1 case). All the GBS strains were sensitive to penicillin and linezolid (13/13, 10/10), the susceptibility to levofloxacin, ampicillin and vancomycin were 11/12, 9/10, 8/13 respectively.</p><p><b>CONCLUSION</b>The clinical manifestations of neonatal purulent meningitis caused by GBS are usually non-specific. It is associated with long hospitalization, neurological impairments and sequelae. Monitoring of serum CRP level is valuable for early diagnosis. Antepartum prophylaxis, early diagnosis and therapy are vital. Large dose penicillin is the priority choice to treat the neonatal purulent meningitis caused by GBS, linezolid should be used in intractable cases.</p>
Subject(s)
Female , Humans , Infant, Newborn , Male , Pregnancy , Anti-Bacterial Agents , Therapeutic Uses , C-Reactive Protein , Drug Resistance, Bacterial , Fever , Diagnosis , Drug Therapy , Pathology , Follow-Up Studies , Hyponatremia , Leukocyte Count , Meningitis, Bacterial , Diagnosis , Drug Therapy , Pathology , Microbial Sensitivity Tests , Penicillins , Therapeutic Uses , Pregnancy Complications, Infectious , Retrospective Studies , Streptococcal Infections , Diagnosis , Drug Therapy , Pathology , Streptococcus agalactiaeABSTRACT
Objective To investigate the features of brainstem auditoryresponses (BAR) in patients with attention deficit and hyperactive disorder (ADHD), mental retardation and conduct disorder. Methods BAR in children with ADHD ( n =37), mental retardation (MR, n =24) and conduct disorder (CD, n =22), and in normal children ( n =30) were measured by use of Nicolet Spirit electrophysiological instrument delivering stimulation of Clicks. Results The absolute latencies (AL) of wave Ⅲ、Ⅴ recorded from Fz region (WⅢ、Ⅴ/Fz) and wave Ⅲ from Pz region (WⅢ/Pz) as well as the absolute amplitudes (AA) of WⅢ/Fz and WⅤ/Pz were significantly different ( P
ABSTRACT
Objective To investigate the clinical application of various parameters of visual evoked potential (VEP) and auditory evoked potential (AEP) in patients with attention deficit and hyperactive disorder (ADHD), mental retardation (MR) and conduct disorder (CD). Methods Thirty-seven ADHD patients, 24 MR patients, 22 CD patients and 36 normal subjects were included in this study. The VEP and AEP were recorded from every subject and analyzed. Results A significant difference was found among 4 subject groups, with both latencies (Oz/N_1, P_2) and amplitudes of VEP (Cz/P_2, P_3 and Oz/P_3 ) (P