Infected cephalohematomas and underlying osteomyelitis: a case-based review

Area of Science:

• Neonatal infections
• Pediatric infectious diseases
• Clinical case reports

Background:

• Cephalohematomas are common neonatal sub-periosteal blood collections, typically resolving spontaneously.
• Infection is a rare complication, potentially leading to osteomyelitis, meningitis, or sepsis.
• Commonly implicated pathogens include Escherichia coli and Staphylococcus species.

Observation:

• This report details the first case of an infected cephalohematoma and underlying osteomyelitis caused by Morganella morganii in a neonate.
• Risk factors included vacuum-assisted delivery and suspected postnatal pneumonia.
• The neonate presented with an infected right parietal cephalohematoma and concurrent osteomyelitis.

Findings:

• Morganella morganii was identified in blood and cephalohematoma aspirate cultures.
• The infant received a 6-week course of intravenous meropenem.
• Complete resolution of both the cephalohematoma and osteomyelitis was achieved.

Implications:

• Aspiration of infected cephalohematomas is vital for diagnosis and therapy.
• Prompt investigation and treatment, including drainage, debridement, and antibiotics, are essential.
• The co-occurrence of infected cephalohematoma and osteomyelitis may be more frequent than previously recognized.