極早産児の遅発性B群連鎖球菌感染症と重度の気管支肺異形成症

Late-onset group B streptococcus infections and severe bronchopulmonary dysplasia in an extremely preterm born infant.

• Raymond Suffolk
• Lone Agertoft
• Malene Johansen
• Gitte Zachariassen

抄録

この症例報告は、妊娠24週の極早産で生まれた男児で、出生体重が極端に少なく、重度の気管支肺異形成を呈し、155日間の機械換気が必要であった。また、生後4ヶ月以内にB群連鎖球菌（GBS）感染を5回繰り返しており、GBS感染のたびに呼吸器の状態が明らかに悪化していた。機械的人工呼吸からの離床は困難であった。最終的には生後7ヶ月で抜管し，国際的に推奨されている高用量メチルプレドニゾロンを投与した後，機械的人工呼吸を行わないようにした．5回目の培養後，リファンピシンを経口投与し，ペニシリンを静脈内投与したところ，GBSは再発しなかった．生後22ヶ月の時点で、この男児は呼吸器のサポートを必要としなくなり、神経学的発達も約6ヶ月遅れていた。

This case report is about a boy born extremely preterm at gestational age of 24 weeks, with extremely low birth weight, developing severe bronchopulmonary dysplasia and in need of mechanical ventilation for 155 days. He also had five recurrent infections with group B streptococcus (GBS) within 4 months from birth, and his respiratory condition clearly deteriorated with every GBS infection. It was difficult to wean him from mechanical ventilation. Finally he was extubated when he was 7 months old and kept out of mechanical ventilation after receiving high-dose methylprednisolone, given according to international recommendations. After GBS was cultured for the fifth time, he received oral rifampicin along with intravenous penicillin and after this treatment, GBS did not occur again. At the age of 22 months, the boy no longer needed any respiratory support and he was about 6 months late in his neurological development.

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