Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Late-Onset Group B Streptococcal Meningitis Complicated with Extensive Cerebral Infarction

광범위한 뇌경색증이 합병된 지발형 B군 사슬알균에 의한 수막염 증례

  • Cho, Min Su (Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Yongmin (Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Cho, Hye-Kyung (Department of Pediatrics, Gil Medical Center, Gachon University College of Medicine) ;
  • Choi, Soo-Han (Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine)
  • 조민수 (한림대학교 동탄성심병원 소아청소년과) ;
  • 김용민 (한림대학교 동탄성심병원 소아청소년과) ;
  • 조혜경 (가천대학교 길병원 소아청소년과) ;
  • 최수한 (한림대학교 동탄성심병원 소아청소년과)
  • Received : 2017.09.06
  • Accepted : 2017.09.28
  • Published : 2018.04.25
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Abstract

Group B streptococcus (GBS) is the leading cause of neonatal morbidity and mortality. Late-onset GBS disease commonly manifests as occult bacteremia or meningitis. Approximately 50% of survivors of late-onset meningitis have long-term neurologic sequelae. Cerebrovascular complications are often associated with unfavorable clinical outcomes of GBS meningitis. There have been a few reports of cerebral infarction accompanied by GBS meningitis. We report a 29-day-old girl with severe, widespread cerebral infarction due to late-onset GBS meningitis. Isolated GBS strain from this patient was serotype III, ST-19. Currently, she has cortical blindness and significant developmental delay.

B군 사슬알균은 3개월 미만 영아에서 발생하는 침습성 감염증의 주요한 원인균이다. 신생아 침습성 B군 사슬알균 수막염에 의한 뇌혈관 합병증은 드물게 보고되고 있다. 발열을 주소로 내원한 생후 29일 신생아에서 세균성 수막염이 진단되었다. 입원 3일째 경련이 발생하였고 뇌 자기공명영상에서 다발성의 광범위한 대뇌피질(양측 전두엽, 측두엽 및 후두엽)과 뇌량 및 좌측 후두엽에서 급성 뇌경색증 합병된 소견을 보였다. 환아의 혈액과 뇌척수액에서 B군 사슬알균이 분리되었고 serotype III, ST-19으로 확인되었다. 현재 환아는 피질맹과 발달 지연을 보이고 있다.

Keywords

References

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