Viridans streptococcal bacteremia-related encephalopathy in childhood with malignancy.
Viridans streptococcal bacteremia is a prognostic factor in pediatric patients with malignant disease accompanied by severe neutropenia. Here the authors describe 4 patients with viridans streptococcal bacteremia-related encephalopathy who showed serious complications, which included seizures and loss of consciousness. Therapy for relief of brain edema on seizures was started quickly, and included the administration of midazolam, dexamethasone, and mannitol with antimicrobial therapy. The treatment was successfully completed without sequelae. The authors registered 28 episodes of viridans streptococcal bacteremia in their hospital. The peak of serum C-reaction protein was higher in viridans streptococcal bacteremia patients with encephalopathy than in those without encephalopathy. The authors concluded that viridans streptococcal bacteremia can induce encephalopathy in pediatric patients with malignancy and that it is crucial to establish an accurate diagnosis and initiate therapy as soon as possible.
Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan. syuya@dokkyomed.ac.jp
Yuya
Y
Sato
Mayuko
M
Okuya
Susumu
S
Hagisawa
Takashi
T
Matsushita
Keitaro
K
Fukushima
Hidemitsu
H
Kurosawa
Kenichi
K
Sugita
Osamu
O
Arisaka
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D001927:Brain Diseases / Q000150:complications* / Q000382:microbiology*; D002648:Child; D002908:Chronic Disease; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009447:Neuroblastoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D009503:Neutropenia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D012512:Sarcoma, Ewing / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D034363:Viridans Streptococci / Q000187:drug effects / Q000502:physiology*