Meningites bacterianas no recém-nascido: estudo de 20 casos

Ribeiro, Valeriana Moura; Armbrust-Figueiredo, J.; Melo, Aurea Nogueira

doi:10.1590/S0004-282X1977000400007

Resumos

Foram estudados 20 pacientes com meningites purulentas no período neonatal, internados no Hospital das Clínicas de Ribeirão Preto. É analisada a importância de se reconhecer sintomas e sinais mínimos, bem como o quadro clínico da doença já declarada. Os autores tecem considerações sobre o valor do diagnóstico precoce, diante da alta incidência de mortalidade e pelas sequelas graves que ocorrem, apesar do tratamento prolongado com antibióticos.

The cases of 20 patients admited with purulent meningitis in the neonatal period are reported. The authors analyse the importance in recognizing the minimal signals and symptoms, as weel as the clinical patterns of the manifested disease. Some considerations are draw about the values of the early diagnostic before the high incidence of mortality and the gravity of sequaele that occur besides the high doses and long term antimicrobial therapy.

Meningites bacterianas no recém-nascido: estudo de 20 casos

Purulent meningitis in the newborn: a study of 20 cases.

Valeriana Moura Ribeiro^I; J. Armbrust-Figueiredo^II; Aurea Nogueira Melo^III

^IProfessor Assistente: Disciplina de Neurologia do Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

^IIProfessor Catedrático: Disciplina de Neurologia do Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

^IIIMédico Residente: Disciplina de Neurologia do Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

RESUMO

Foram estudados 20 pacientes com meningites purulentas no período neonatal, internados no Hospital das Clínicas de Ribeirão Preto. É analisada a importância de se reconhecer sintomas e sinais mínimos, bem como o quadro clínico da doença já declarada. Os autores tecem considerações sobre o valor do diagnóstico precoce, diante da alta incidência de mortalidade e pelas sequelas graves que ocorrem, apesar do tratamento prolongado com antibióticos.

SUMMARY

The cases of 20 patients admited with purulent meningitis in the neonatal period are reported. The authors analyse the importance in recognizing the minimal signals and symptoms, as weel as the clinical patterns of the manifested disease. Some considerations are draw about the values of the early diagnostic before the high incidence of mortality and the gravity of sequaele that occur besides the high doses and long term antimicrobial therapy.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Departamento de Neuropsiquiatria e Psicologia Médica, Faculdade de Medicina - 14.100 Ribeirão Preto, SP - Brasil.

1. BARCLAY, N. - High frequency of salmonella species as a cause of neonatal meningitis in Ibadan, Nigeria, Acta Paediat. Scand. 60:540, 1971.
2. BERMAN, P. H. & BANKER, Q. Q. - Neonatal meningitis: a clinical and pathologic study of 29 cases. Pediatrics 38:6, 1966.
3. BUSH, R. T. - Purulent meningitis of the newborn: a survery of 28 cases. N. Z. med. J. 73:278, 1971.
4. CHEVRIE, S.; AICARDI, S.; DHAUSSY & THIEFFRY - Les meningites purulentes du nouveau-né. Franc. Péd. 25:849, 1968.
5. COEN, R.; GRUSH, O. & KAUDER, E. - Studies of bactericidal activity and metabolism of the leukocyte in full term neonates. J. Pediatr. 75:400, 1969.
6. CONVERSE, G. M.; GWALTNEY, J. M. JR.; STRASSBURG, D. A. & HENDLEY, J. O. - Alteration of cerebrospinal fluid finding by partial treatment of bacterial meningitis. J. Pediat. 83:220, 1973.
7. DELAITRE, R.; TESTARD, R.; VARLET PH.; COLLIN, G. & ACHARD, J. - Prognostic atual des méningites purulents du nouveau-né. Arch. Franç. Péd. 26: 559, 1969.
8. DIAMENT, A. - Leptomeningites purulentas nos recém-nascidos. Pediat. Prát. 35: 223, 1964.
9. D'OELSNITZ, K.; SAUSOT, M. & TARAMASCO, ch. - Les méningites purulentes neonatales. Arch. Franç. Pédiat. 22:489, 1967.
10. DUPOUY, D.; MESMIN, F.; PENNAFORTE, F.; PUIG, M. & COUCHOT, J. - Purulent meningitis in the newborn: report of 144 cases. Sem. Hop. Ann. Pediat. 47:507, 1971.
11. ETIENNE, M.; CURIONI, S. & LAPLANE, R. - La gravite cie méningites bacteriennes néonatales. Ann. Ped. 12:421, 1965.
12. FITZHARDINGE, P. M.; KAZEMI, M.; RAMSAY, M. & STERN, L. - Long term sequelae of neonatal meningitis. Develop. Med. Child Neurol. 16:3, 1974.
13. FRIEDE, R. L. - Cerebral infarcts complicating neonatal leptomeningitis. Acta Neuropathol. 23:245, 1973.
14. GROOVER, R. V.; SUTHERLAND, J. M. & LANDING, B. H. - Purulent meningitis of newborn infants. N. Engl. J. Med. 264:1115, 1969.
15. GWYNN, C. M. & GEORGE, R. H. - Neonatal citrobacter meningitis. Arch. Dis. Childh. 48:455, 1973.
16. HAMBLETON, G. & DAVIES, P. A. - Bacterial meningitis: somes aspects of diagnosis and treatment. Arch. Dis. Childh. 50:674, 1975.
17. JOLY, P. - Purulent neonatal meningitis. Rev. Prat. 21:3945, 1971.
18. LEE, E. L.; ROBINSON, M. J.: THONG, M. L. & PUTHUCHEARY, S. D. - Rifamycin in neonatal flavobacteria meningitis. Arch. Dis. Childh. 51:209, 1976.
19. LEFÈVRE, A. B. - Tratamento das méningites purulentas. Rev. Paul. Med. 57: 402, 1960.
20. LEROUX, N.; PENNAFORTE, F.; PUIG, M.; DUPOUY, D. & LEROUX, B. - Bacterial meningitis in the newborn: report of 28 cases. Sem. Hop. Ann. Pediatr. 47:517, 1971.
21. LIVRAMENTO, J. A.; LUZ, B. R.; HAUSSEN, S. R. & SPINA-FRANÇA, A. - Citometria do líquido cefalorraqueano do recém-nascido normal. Arq. Neuro-Psiquiat. (São Paulo) 32:207, 1974.
22. LORBER, J.; KALHAN, S. C. & MAHGREFTE, B. - Treatment of ventriculitis with gentamicin and cloxacillin in infants born with spina bifida. Arch. Dis Childh. 45:178, 1970.
23. LORBER, J. Neonatal E. coli meningitis, hydrocephalus, respiratory distress syndrome: full recovery after temporary blindness. Proc. Roy. Soc. Med. 66:221, 1973.
24. McCRAKEN, G. H. JR. & EICHENWALD, H. F. - Leukocyte function and the development of opsonic and complement activity in the neonate. Amer. J. Dis. Childh. 121:120, 1971.
25. McCRAKEN, G. H. JR. - The rate of bacteriologic response to antimicrobial therapy in neonatal meningitis. Amer. J. Dis. Childh. 123:547, 1972.
26. McCRACKEN, G. H. JR.; SARFF, L. D.; GLODE, M. P.; MIZE, S. G.; SCHIFFER. M. S. & ROBBINS, J. B. - Relation between Escherichia coli K1 capsular polysaccharide antigen and clinical outcome in neonatal meningitis. Lancet ii :246, 1974.
27. McCRAKEN, G. H. JR. & MISE, S. G. - A controlled study of intratecal antibiotic therapy in gram-negative enteric meningitis of infancy. J. Pediat. 89:66, 1976.
28. McDONALD, R. - Purulent meningitis in newborn babies. Clin. Pediatr. 11:450, 1972.
29. MOELLERING, R. C. JR. & FISCHER, E. G. - Relationship of intraventricular gentamicin levels to cure of meningitis. J. Pediat. 534, 1972.
30. MURALT, G. VON - Importance clinica del intercambio imunologico entre madre e hijo. In Rossi, A. - Imunologia Pediátrica, Argentina Editorial Médico Pan-Americana, Buenos Aires, 1974, pág. 33.
31. SCHULTZ, P. & LEEDS, N. E. - Intraventricular septations complicating neonatal meningitis. J. Neurosurg. 38:620, 1973.
32. WILSON, H. D. & EICHENWALD, H. F. - Sepsis neonatorum. Pediat. Clin. N. Amer. 21:571, 1974.
33. WOISKI, J. R.: REIS, J. B. & BARROS, N. E. V. - Liquido cefalorraqueano do recém-nascido: conceito de normalidade. Arq. Neuro-Psiquiat. (São Paulo) 7:264, 1949.
34. ZOUMBOULAKIS, D.; ANAGNOSTAKIS, D.; ARSENI, A., NICOLOPOULOS, D. & MATSANIOTIS, N. - Gentamicin in the treatment of purulent meningitis in neonates and infants. Acta Paediat. Scand. 62:55, 1973.

Datas de Publicação

Publicação nesta coleção
30 Ago 2012
Data do Fascículo
Dez 1977

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BARCLAY, N. - High frequency of salmonella species as a cause of neonatal meningitis in Ibadan, Nigeria, Acta Paediat. Scand. 60:540, 1971.

[2] 2. BERMAN, P. H. & BANKER, Q. Q. - Neonatal meningitis: a clinical and pathologic study of 29 cases. Pediatrics 38:6, 1966.

[3] 3. BUSH, R. T. - Purulent meningitis of the newborn: a survery of 28 cases. N. Z. med. J. 73:278, 1971.

[4] 4. CHEVRIE, S.; AICARDI, S.; DHAUSSY & THIEFFRY - Les meningites purulentes du nouveau-né. Franc. Péd. 25:849, 1968.

[5] 5. COEN, R.; GRUSH, O. & KAUDER, E. - Studies of bactericidal activity and metabolism of the leukocyte in full term neonates. J. Pediatr. 75:400, 1969.

[6] 6. CONVERSE, G. M.; GWALTNEY, J. M. JR.; STRASSBURG, D. A. & HENDLEY, J. O. - Alteration of cerebrospinal fluid finding by partial treatment of bacterial meningitis. J. Pediat. 83:220, 1973.

[7] 7. DELAITRE, R.; TESTARD, R.; VARLET PH.; COLLIN, G. & ACHARD, J. - Prognostic atual des méningites purulents du nouveau-né. Arch. Franç. Péd. 26: 559, 1969.

[8] 8. DIAMENT, A. - Leptomeningites purulentas nos recém-nascidos. Pediat. Prát. 35: 223, 1964.

[9] 9. D'OELSNITZ, K.; SAUSOT, M. & TARAMASCO, ch. - Les méningites purulentes neonatales. Arch. Franç. Pédiat. 22:489, 1967.

[10] 10. DUPOUY, D.; MESMIN, F.; PENNAFORTE, F.; PUIG, M. & COUCHOT, J. - Purulent meningitis in the newborn: report of 144 cases. Sem. Hop. Ann. Pediat. 47:507, 1971.

[11] 11. ETIENNE, M.; CURIONI, S. & LAPLANE, R. - La gravite cie méningites bacteriennes néonatales. Ann. Ped. 12:421, 1965.

[12] 12. FITZHARDINGE, P. M.; KAZEMI, M.; RAMSAY, M. & STERN, L. - Long term sequelae of neonatal meningitis. Develop. Med. Child Neurol. 16:3, 1974.

[13] 13. FRIEDE, R. L. - Cerebral infarcts complicating neonatal leptomeningitis. Acta Neuropathol. 23:245, 1973.

[14] 14. GROOVER, R. V.; SUTHERLAND, J. M. & LANDING, B. H. - Purulent meningitis of newborn infants. N. Engl. J. Med. 264:1115, 1969.

[15] 15. GWYNN, C. M. & GEORGE, R. H. - Neonatal citrobacter meningitis. Arch. Dis. Childh. 48:455, 1973.

[16] 16. HAMBLETON, G. & DAVIES, P. A. - Bacterial meningitis: somes aspects of diagnosis and treatment. Arch. Dis. Childh. 50:674, 1975.

[17] 17. JOLY, P. - Purulent neonatal meningitis. Rev. Prat. 21:3945, 1971.

[18] 18. LEE, E. L.; ROBINSON, M. J.: THONG, M. L. & PUTHUCHEARY, S. D. - Rifamycin in neonatal flavobacteria meningitis. Arch. Dis. Childh. 51:209, 1976.

[19] 19. LEFÈVRE, A. B. - Tratamento das méningites purulentas. Rev. Paul. Med. 57: 402, 1960.

[20] 20. LEROUX, N.; PENNAFORTE, F.; PUIG, M.; DUPOUY, D. & LEROUX, B. - Bacterial meningitis in the newborn: report of 28 cases. Sem. Hop. Ann. Pediatr. 47:517, 1971.

[21] 21. LIVRAMENTO, J. A.; LUZ, B. R.; HAUSSEN, S. R. & SPINA-FRANÇA, A. - Citometria do líquido cefalorraqueano do recém-nascido normal. Arq. Neuro-Psiquiat. (São Paulo) 32:207, 1974.

[22] 22. LORBER, J.; KALHAN, S. C. & MAHGREFTE, B. - Treatment of ventriculitis with gentamicin and cloxacillin in infants born with spina bifida. Arch. Dis Childh. 45:178, 1970.

[23] 23. LORBER, J. Neonatal E. coli meningitis, hydrocephalus, respiratory distress syndrome: full recovery after temporary blindness. Proc. Roy. Soc. Med. 66:221, 1973.

[24] 24. McCRAKEN, G. H. JR. & EICHENWALD, H. F. - Leukocyte function and the development of opsonic and complement activity in the neonate. Amer. J. Dis. Childh. 121:120, 1971.

[25] 25. McCRAKEN, G. H. JR. - The rate of bacteriologic response to antimicrobial therapy in neonatal meningitis. Amer. J. Dis. Childh. 123:547, 1972.

[26] 26. McCRACKEN, G. H. JR.; SARFF, L. D.; GLODE, M. P.; MIZE, S. G.; SCHIFFER. M. S. & ROBBINS, J. B. - Relation between Escherichia coli K1 capsular polysaccharide antigen and clinical outcome in neonatal meningitis. Lancet ii :246, 1974.

[27] 27. McCRAKEN, G. H. JR. & MISE, S. G. - A controlled study of intratecal antibiotic therapy in gram-negative enteric meningitis of infancy. J. Pediat. 89:66, 1976.

[28] 28. McDONALD, R. - Purulent meningitis in newborn babies. Clin. Pediatr. 11:450, 1972.

[29] 29. MOELLERING, R. C. JR. & FISCHER, E. G. - Relationship of intraventricular gentamicin levels to cure of meningitis. J. Pediat. 534, 1972.

[30] 30. MURALT, G. VON - Importance clinica del intercambio imunologico entre madre e hijo. In Rossi, A. - Imunologia Pediátrica, Argentina Editorial Médico Pan-Americana, Buenos Aires, 1974, pág. 33.

[31] 31. SCHULTZ, P. & LEEDS, N. E. - Intraventricular septations complicating neonatal meningitis. J. Neurosurg. 38:620, 1973.

[32] 32. WILSON, H. D. & EICHENWALD, H. F. - Sepsis neonatorum. Pediat. Clin. N. Amer. 21:571, 1974.

[33] 33. WOISKI, J. R.: REIS, J. B. & BARROS, N. E. V. - Liquido cefalorraqueano do recém-nascido: conceito de normalidade. Arq. Neuro-Psiquiat. (São Paulo) 7:264, 1949.

[34] 34. ZOUMBOULAKIS, D.; ANAGNOSTAKIS, D.; ARSENI, A., NICOLOPOULOS, D. & MATSANIOTIS, N. - Gentamicin in the treatment of purulent meningitis in neonates and infants. Acta Paediat. Scand. 62:55, 1973.