莫西沙星治疗超早产儿人型支原体脑膜炎1例

Moxifloxacin treatment for Mycoplasma hominis meningitis in an extremely preterm infant

摘要:

患儿男，生后2 h，因早产（胎龄27⁺⁵周）、生后气促2 h入院。患儿入院后出现发热，血C反应蛋白升高，生后第4天脑脊液宏基因组二代测序示人型支原体阳性（序列数9 898）；生后第8天复查脑脊液宏基因组二代测序示人型支原体阳性（序列数56 806）阳性。患儿人型支原体化脓性脑膜炎诊断明确，抗生素调整为莫西沙星静脉滴注［5 mg/（kg·d）］，总疗程4周。治疗后患儿脑脊液检查恢复正常，于生后第76天治愈出院。该文对新生儿人型支原体化脓性脑膜炎的诊断和治疗进行重点描述，介绍超早产儿人型支原体化脓性脑膜炎的多学科诊疗。

Abstract:

The patient, a male newborn, was admitted to the hospital 2 hours after birth due to prematurity (gestational age 27⁺⁵ weeks) and respiratory distress occurring 2 hours postnatally. After admission, the infant developed fever and elevated C-reactive protein levels. On the fourth day after birth, metagenomic next-generation sequencing of cerebrospinal fluid indicated a positive result for Mycoplasma hominis (9 898 reads). On the eighth day, a retest of cerebrospinal fluid metagenomics confirmed Mycoplasma hominis (56 806 reads). The diagnosis of purulent meningitis caused by Mycoplasma hominis was established, and the antibiotic treatment was switched to moxifloxacin [5 mg/(kg·day)] administered intravenously for a total of 4 weeks. After treatment, the patient's cerebrospinal fluid tests returned to normal, and he was discharged as cured on the 76th day after birth. This article focuses on the diagnosis and treatment of neonatal Mycoplasma hominis purulent meningitis, introducing the multidisciplinary diagnosis and treatment of the condition in extremely preterm infants.