B군 B-용혈성 연쇄상 구균에 의한 신생아 뇌막염 12례의 임상적 고찰

Abstract

A clinical study was made on 12 cases of neonatal Group Bβ-hemolytic streptococcal(=GBS)meningitis, who were admitted to the department of Pediatrics, Dong-San Hospital, Keimyung University during the period of 3 years from Aug 1989 to Jul 1992. The following results were obtained 1) GBS was cultured in 12 cases(57.1%) among 21 neonatal meningitis admitted during the same period. 2) Male and female ratio was 1.4 : 1, and 4 cases had early-onset and 8 cases had late-onset. 3) In 6(50%) out of 12 cases, obstetric factors were noted, including premature rupture of membrane (2 cases), premature delivery (1 case), asphyxia (1 case), cesarean section (1 case) and maternal toxemia (1 case). 4) The clinical manifestations were fever (91.7%), lethargy and poor feeding (83.3%), vomiting and irritability (50%), convulsion and bulging fontanel in order. 5) Associated diseases were GBS sepsis (8 cases), pneumonia (2 cases), hyperbilirubinemia (2 cases), etc. 6) Cerebrospinal fluid findings were increased cells (250-12600/㎣), decreased sugar (1-11mg%), increased protein (220-678mg%) and the CBC differential ratio was less than 1.0 in all cases. 7) Overall survival rate was 83.3% with 75% in early-onset disease, and 87.5% in late-onset disease. 8) The acute neurologic complications were noted in 5 cases(45.5%) including subdural hemorrhage, brain swelling and cerebral infarction.