{"_buckets": {"deposit": "b6891bb4-3e1b-4adb-a823-ae60c0ec4e0f"}, "_deposit": {"id": "33419", "owners": [], "pid": {"revision_id": 0, "type": "depid", "value": "33419"}, "status": "published"}, "_oai": {"id": "oai:niigata-u.repo.nii.ac.jp:00033419", "sets": ["456", "1931"]}, "item_7_alternative_title_1": {"attribute_name": "その他のタイトル", "attribute_value_mlt": [{"subitem_alternative_title": "Congenital Dermal Sinus Recognized by an Episode of Bacterial Meningitis"}]}, "item_7_biblio_info_6": {"attribute_name": "書誌情報", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "2018-05", "bibliographicIssueDateType": "Issued"}, "bibliographicIssueNumber": "5", "bibliographicPageEnd": "207", "bibliographicPageStart": "203", "bibliographicVolumeNumber": "132", "bibliographic_titles": [{"bibliographic_title": "新潟医学会雑誌"}, {"bibliographic_title": "新潟医学会雑誌", "bibliographic_titleLang": "en"}]}]}, "item_7_description_4": {"attribute_name": "抄録", "attribute_value_mlt": [{"subitem_description": "症例は10ヶ月の男児．発熱とけいれんを主訴に当院に入院した．Haemophilus influenzae type b (Hib) ワクチンおよび肺炎球菌ワクチンは接種済み．健診で異常を指摘されたことはなかった．入院時，多核球優位の髄液細胞数増多を認め，細菌性髄膜炎と診断された．セフトリアキソン，バンコマイシン，デキサメタゾンで治療を開始され，一旦は解熱したが，入院4日目から再度発熱した．腰仙部中央に痂皮形成を伴う発赤があり，痂皮下に軽微な陥凹を認めたため腰部MRIを施行した．皮膚洞、硬膜内に連続する嚢状構造物を認め，先天性皮膚洞と硬膜内膿瘍が疑われた．入院8日目の髄液検査では再度細胞数の増多を認めた．標準的な抗菌薬治療でも解熱せず，外科的介入が必要と判断された．入院11日目に高次医療機関に転院し，皮膚洞と嚢胞を摘出された．転院後の髄液培養でStaphylococcus lugdunensisが検出された．病理の結果、先天性皮膚洞，類皮嚢胞と診断された．術後経過は良好で転院26日目に退院した．術後の運動発達は良好で，1歳で独歩を獲得している．本症例は髄膜炎が先天性皮膚洞発見の契機となった．非感染時の皮膚症状が軽微で健診では確認が困難であったが，入院時の診察で皮膚異常を認めたことで診断に至った．先天性皮膚洞は早期発見と介入が重要である．皮膚所見が軽微でも，殿裂内にない陥凹等のリスクのある症例を見逃さないことが大切と考えられた．Hib，肺炎球菌ワクチン接種済みの症例や通常想定されない起因菌の細菌性髄膜炎では，解剖学的異常を含めた基礎疾患の可能性を特に考えるべきである．", "subitem_description_type": "Abstract"}]}, "item_7_full_name_3": {"attribute_name": "著者別名", "attribute_value_mlt": [{"nameIdentifiers": [{"nameIdentifier": "176215", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Harada, Mizuki"}]}, {"nameIdentifiers": 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