Clinical analysis of 6 cases of Streptococcus suis meningitis

Abstract

Objective To analyze the clinical characteristics of Streptococcus suis meningitis.

Methods Data of epidemiology, clinic, laboratory, hearing examination, cranial imaging examination and treatment outcome of 6 cases of Streptococcus suis meningitis confirmed by the Hainan General Hospital from February 2018 to October 2019 were collected, and a retrospective analysis of clinical features were analyzed.

Results The 6 patients were male, ages ranged from 34 to 67 years old, with an average age of (54.8±11.56) years old, they are all farmers. The main clinical symptoms were acute onset, headache, fever and hearing loss. Blood examination showed high hemogram, high CRP level, and CSF examination showed high level of leukocyte and proteins. Five patients were positive in blood culture, 2 patients were positive in CSF culture, metagenomic next-generation sequencing in 5 cases indicated that Streptococcus suis. CT examination showed no abnormalities in 3 patients, 2 patients had blurred gray and white matter boundaries, and brain tissue swelling, and 1 patient had low-density shadow in the right temporal occipital junction area. After the diagnosis, ceftriaxone combined with dexamethasone was used (2 g/q12 h ceftriaxone, 21 d, dexamethasone 10 mg qd, 7-10 d), at the same time, according to the disease condition, the treatment of dehydrating, brain protectant was used. Three weeks later, the patients were all improved, but 5 patients were left with hearing impairment.

Conclusion It is necessary to pay attention to the diagnosis and treatment of Streptococcus suis in clinic. When encountering suspicious patients, we should finish the aetiological examination and give treatment in time to avoid the occurrence of sequelae.

Abstract

摘要： 目的 探讨猪链球菌脑膜炎的临床特点。 方法 回顾性分析2018年2月一2019年10月于海南省人民医院 确诊住院的6例猪链球菌脑膜炎患者的流行病学、临床表现、实验室检查、听力检查、头颅影像学检查及治疗转归等资 料, 分析其临床特点。 结果 6例患者均为男性, 年龄34~67岁, 平均年龄(54.8±11.56)岁, 均为农民。主要的临床表现 为急性起病, 临床症状以头痛、发热、听力下降为主。6例患者的血象及炎性指标均有升高, 脑脊液检查提示白细胞及 蛋白质均有增高, 氯化物基本正常。5例血培养阳性, 2例脑脊液培养阳性, 5例脑脊液二代基因测序提示为猪链球菌。 3例患者头颅CT检查未见异常, 2例脑灰白质分界模糊, 脑组织肿胀, 1例右侧颞枕叶交界区低密度影。在确诊后给予 头孢曲松联合地塞米松治疗(头孢曲松2g, 1次/12h, 连续21 d;地塞米松10 mg, 1次/d, 连续7~10d), 同时根据病情给 予脱水、脑保护剂等治疗。3周后6例患者症状均明显好转, 但5例患者遗留有听力障碍。 结论 临床医生应提高对人 感染猪链球菌病的认识, 对疑似猪链球菌感染患者及时行病原检测, 避免后遗症的发生。