关键词: Antibiotics Encephalitis Meningitis Raised ICP Status epilepticus Steroids Antibiotics Encephalitis Meningitis Raised ICP Status epilepticus Steroids

Mesh : Anti-Infective Agents / therapeutic use Anticonvulsants / therapeutic use Central Nervous System Infections / diagnosis therapy Chemoprevention Child Electroencephalography Fluid Therapy Glucocorticoids / therapeutic use Glycerol / therapeutic use Hematologic Tests Humans Incidence Intracranial Hypertension / prevention & control Neuroimaging Respiration, Artificial Seizures / drug therapy etiology Spinal Puncture Vaccination Anti-Infective Agents / therapeutic use Anticonvulsants / therapeutic use Central Nervous System Infections / diagnosis therapy Chemoprevention Child Electroencephalography Fluid Therapy Glucocorticoids / therapeutic use Glycerol / therapeutic use Hematologic Tests Humans Incidence Intracranial Hypertension / prevention & control Neuroimaging Respiration, Artificial Seizures / drug therapy etiology Spinal Puncture Vaccination

来  源:   DOI:10.1007/s12098-017-2583-y

Abstract:
CNS infections in children are medical emergency and are associated with high mortality and morbidity. For diagnosis, a high index of suspicion is required. Clinical assessment should be supplemented by laboratory investigations including CSF Gram stain and cultures, blood culture, PCR on CSF, serological tests, and imaging. Commonly associated life threatening complications include coma, seizure, raised intracranial pressure (ICP), focal deficits, shock, respiratory failure, and fluid and electrolyte abnormalities. Immediate management should first address control of airway, breathing and circulation; protocolized management of raised ICP and status epilepticus; maintaining adequate intravascular volume; and close monitoring for early detection of complications. Appropriate antimicrobial agents should be administered promptly according to the suspected pathogen. Clinical evaluation, laboratory workup, specific antimicrobial therapy, supportive treatment, and management of associated complications should go hand in hand in a protocolized way for better outcome.
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