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患儿男,6个月。因“发热3天、抽搐两次”入院。体检:体温38.8℃,精神萎靡,前囟饱满,颈有抵抗。心肺无异常,布氏征(+),血白细胞16800/立方毫米,中性粒细胞80％。脑脊液外观呈脓性,镜检脓细胞(++)。拟诊为“化脓性脑膜炎”,给予大剂量青霉素、氨苄青霉素、地塞米松、甘露醇等治疗。次日抽搐停止,3天后体温降至正常。于入院第6天体温又复升高,患儿烦躁不安,做颅骨透光试验两次均为阴性。停用青霉素,给予先锋霉素V(Cefazolin)治疗,仍持续低热。第11天出现左侧肢体活动不灵,肌张力减低,又做透光试验仍为阴性。复查脑脊液外观清晰,细胞数8个,糖、氯化物均正常,洗净头皮污垢后行右侧诊断性硬脑膜下穿刺,流出淡黄色液体20毫升,当晚再次做透光试验,右侧透光区明显扩大,经反复硬膜下穿刺放液,体温降至正常,左侧肌张力逐
Children male, 6 months. Due to “fever 3 days, convulsions twice” admitted. Physical examination: body temperature 38.8 ℃, apathetic, full bones, neck resistance. Cardiopulmonary no abnormalities, Brinell’s sign (+), blood leukocytes 16800 / cubic mm, neutrophils 80%. Cerebrospinal fluid showed purulent appearance, pus examination of the mirror (++). To be diagnosed as “purulent meningitis”, given large doses of penicillin, ampicillin, dexamethasone, mannitol and other treatment. Convulsions stopped the next day, 3 days after the temperature dropped to normal. On the 6th day after admission, the body temperature increased again and again. The children were irritable and the skull translucent test was negative twice. Disable penicillin, given cefazolin V treatment (Cefazolin), continued low fever. On the 11th day, the left limb movement was unbalanced, muscle tension decreased, and the light transmission test was still negative. Review of cerebrospinal fluid clear appearance, the number of cells 8, sugar, chloride are normal, wash the scalp dirt on the right after the diagnosis of subdural puncture, out of a light yellow liquid 20 ml, again the night through the light test, the right side of the light District significantly expanded after repeated subdural puncture liquid, body temperature dropped to normal, the left muscle tension by