ABSTRACT
Objective:To investigate the clinical characteristics of septic shock caused by an invasive pneumococcal disease (IPD) and analyze the factors that affect the prognosis of this disease.Methods:We retrospectively analyzed the clinical data of 42 children with an IPD-caused septic shock, who received treatment in The Second Hospital of Jiaxing from January 2015 to December 2020, and evaluated the clinical characteristics and prognosis of this disease.Results:The age of the included children averaged 1.3 (0.75, 4.15) years. The Pediatric Index of Mortality 2 was (23.38 ± 9.26) points. Infections were primarily in the blood and brain. Eighteen cases were sensitive to penicillin, 20 cases to cefepime, 22 cases to cefotaxime, and 20 cases to meropenem, vancomycin, and linezolid simultaneously. The mortality was 61.90% (26/42). The Pediatric Index of Mortality 2 [(37.17 ± 10.58) points vs. (0.92 ± 0.39) points, t = 17.45, P < 0.001], and the rate of children developing an intracranial hypertension crisis (69.23% vs. 25.03%) ( χ2 = 7.77, P = 0.05) were significantly higher in the death group than in the survival group. Compared with the survival group, the thoracic infection rate was significantly lower in the death group (7.69% vs. 50.00%, P < 0.05). Conclusion:Most children with an IPD-caused septic shock are young, and most infection sites are in the brain and blood. The IPD-caused septic shock is highly resistant to cephalosporins and penicillin and has high mortality because of an intracranial hypertension crisis. The IPD-caused septic shock should be screened and treated as early as possible.
ABSTRACT
Objective:To investigate the changes and clinical significance of neuron specific enolase (NSE) and S-100β protein levels in cerebrospinal fluid of children with viral encephalitis and meningitis.Methods:Sixty children with viral encephalitis and meningitis admitted to The Second Hospital of Jiaxing from February 2018 to December 2020 were included in the observation group. An additional 30 children without central nervous system diseases who concurrently received treatment in the same hospital were included in the control group. The value of NSE and S-100β protein levels in the diagnosis and treatment of viral encephalitis and meningitis in chiblren were analyzed.Results:NSE and S-100β protein levels in the observation group were (17.683 ± 1.321) μg/L and (1.755 ± 0.129) μg/L, respectively, which were significantly higher than (5.267 ± 0.907) μg/L and (0.827 ± 0.172) μg/L in the control group ( t = 46.25, 28.65, both P < 0.001). NSE and S-100β protein levels in children with mild viral encephalitis and meningitis were (15.219 ± 0.870) μg/L and (1.456 ± 0.113) μg/L, respectively, which were significantly lower than (19.893 ± 1.066) μg/L and (2.014 ± 0.085) μg/L in children with severe viral encephalitis and meningitis ( t = -18.69, -21.32, both P < 0.001). In children with viral encephalitis and meningitis, NSE and S-100β protein levels during the acute phase were (17.250 ± 1.188) μg/L and (1.683 ± 0.096) μg/L, respectively, which were significantly higher than (11.150 ± 0.971) μg/L and (1.147 ± 0.098) μg/L during the convalescence phase ( t = 30.79, 30.27, both P < 0.001). Conclusion:NSE and S-100β protein levels in cerebrospinal fluid of children with viral encephalitis and meningitis can help evaluate the severity of viral encephalitis and meningitis in children, providing important clinical application value for judging the development and prognosis of viral encephalitis and meningitis.