目的分析早产儿真菌性脑膜炎的临床特点及随访情况,为合理诊治及随访提供依据。方法选择2008年9月至2012年8月我院早产新生儿病房收治的真菌性脑膜炎早产儿临床资料进行回顾性分析,总结患儿一般资料、临床表现、辅助检查、治疗、转归和随访情况。结果研究期间共收治7例真菌性脑膜炎早产儿,患儿胎龄均<32周,其中极低出生体重儿4例。7例患儿感染前全部应用胃肠外营养,接受了三代以上头孢类抗生素治疗。诊断日龄9~30天,表现为呼吸暂停、发热、惊厥、反应低下。6例有血常规改变,4例C反应蛋白明显升高,5例血培养为白色念珠菌,对氟康唑及两性霉素B均敏感,2例为白色念珠菌生物变种,仅对两性霉素B敏感,脑脊液检查均有白细胞数和总蛋白的增高,2例脑脊液培养阳性,5例患儿有明显颅内影像学改变。5例给予氟康唑治疗,2例给予两性霉素B治疗,疗程21~50天,5例治愈出院,1例好转出院,1例放弃治疗。治疗过程中未见严重药物不良反应。7例患儿除1例放弃治疗外,余均随访,4例患儿神经发育情况基本正常,头颅影像学正常;其余2例神经发育严重落后的患儿,均于起病2周左右头颅影像学证实形成了脑软化灶或液化区。结论早产儿真菌性脑膜炎多见于胎龄<32周的早产儿,以白色念珠菌感染多见,呼吸暂停为早期主要临床表现,可能与长期接受胃肠外营养和应用广谱抗生素等因素有关,头颅B超是经济有效的检查方法,颅内形成软化灶或液化区可能提示其预后不佳。 Objective To analyze the clinical features and follow-up of fungal meningitis in premature infants and provide the basis for proper diagnosis and follow-up. Methods From September 2008 to August 2012, the clinical data of mycotic fungal meningitis in premature neonates admitted to our hospital were analyzed retrospectively. The general information, clinical manifestations, auxiliary examination, treatment, outcome and follow-up were summarized Happening. Results A total of 7 preterm infants with fungal meningitis were enrolled during the study. The gestational age was <32 weeks, of which 4 were very low birth weight infants. Seven cases of children before the application of parenteral nutrition, received more than three generations of cephalosporins antibiotics. Diagnosis of age 9 to 30 days, manifested as apnea, fever, convulsions, reaction was low. 6 cases of blood routine changes, 4 cases of C-reactive protein was significantly elevated in 5 blood cultures of Candida albicans, fluconazole and amphotericin B are sensitive to 2 strains of Candida albicans biological species, only amphotericosis B sensitive, cerebrospinal fluid tests have increased the number of white blood cells and total protein, 2 cases of cerebrospinal fluid culture positive, 5 cases of children with significant intracranial imaging changes. 5 cases were treated with fluconazole, 2 cases were given amphotericin B treatment, the course of 21 to 50 days, 5 patients were discharged, 1 patient was discharged, 1 patient gave up treatment. No severe adverse drug reactions were observed during the course of treatment. All the 7 cases were followed up except for 1 case. The neurodevelopment in 4 cases was normal and the cranial imaging was normal. The other 2 cases of children with severe neurological development lagged at about 2 weeks after onset Learn to form a brain softening or liquefaction area. Conclusions Fungal meningitis in preterm infants is more common in preterm infants with gestational age <32 weeks. Candida albicans infection is more common and apnea is the main clinical manifestation in early stage, which may be related to long-term parenteral nutrition and the use of broad-spectrum antibiotics , B-head skull is a cost-effective method of examination, the formation of intracranial soft tissue or liquefied zone may indicate poor prognosis.