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Escherichia coli Meningitis after Rotavirus Gastroenteritis in an Infant

Gamze Ozgurhan1, Oznur Vermezoglu1, Didem Ocal Topcu1

  • 1Department of Pediatrics, Süleymaniye Maternity and Children's Training and Research Hospital, Istanbul, Turkey.

Case Reports in Infectious Diseases
|October 15, 2016
PubMed

Insights

A rare case of bacterial meningitis caused by Escherichia coli (E. coli) occurred in an infant following rotavirus gastroenteritis. Prompt antibiotic treatment is crucial for managing this severe secondary infection in pediatric patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Clinical Case Reports

Background:

  • Rotavirus gastroenteritis is common in children.
  • Secondary bacterial sepsis after rotavirus is rare.
  • Gram-negative bacilli are a common cause of infant meningitis but rarely follow gastroenteritis.

Purpose of the Study:

  • To report an extremely rare case of Escherichia coli (E. coli) meningitis in an infant secondary to rotavirus gastroenteritis.
  • To highlight the importance of prompt diagnosis and treatment of secondary bacterial infections following viral gastroenteritis in pediatric patients.

Main Methods:

  • Case presentation of a 2.5-month-old infant with fever, vomiting, and diarrhea.
  • Diagnostic workup included stool rotavirus antigen test, blood cultures, and cerebrospinal fluid (CSF) analysis.
  • Empirical antibiotic treatment with vancomycin and cefotaxime, adjusted based on culture results.

Main Results:

  • Stool sample tested positive for rotavirus antigen.
  • Blood and CSF cultures confirmed Escherichia coli (E. coli) infection, indicating meningitis.
  • The infant received 21 days of cefotaxime treatment and was discharged with minimal hydrocephalus.

Conclusions:

  • Secondary bacterial sepsis, specifically E. coli meningitis, following rotavirus gastroenteritis is an exceptionally rare clinical event.
  • Early recognition and initiation of appropriate antibiotic therapy are critical due to the high mortality and morbidity associated with such infections.
  • This case underscores the need for vigilance in diagnosing bacterial infections in infants presenting with symptoms suggestive of gastroenteritis.

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