광범위한 뇌경색증이 합병된 지발형 B군 사슬알균에의한 수막염 증례
Late-Onset Group B Streptococcal Meningitis Complicated with Extensive Cerebral Infarction
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초록
B군 사슬알균은 3개월 미만 영아에서 발생하는 침습성 감염증의 주요한 원인균이다. 신생아 침습성 B 군 사슬알균 수막염에 의한 뇌혈관 합병증은 드물게 보고되고 있다. 발열을 주소로 내원한 생후 29일신생아에서 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-19으로확인되었다. 현재 환아는 피질맹과 발달 지연을 보이고 있다.
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.
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