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Relapsing E. coli K1 antigen meningitis in a newborn
Archives of Disease in Childhood
|February 1, 1977
Summary
Neonatal meningitis caused by Escherichia coli K1 can relapse despite adequate treatment. Intraventricular gentamicin and systemic cotrimoxazole successfully treated a relapsed case, highlighting the importance of suspecting and treating ventriculitis in newborns.
Area of Science:
- Neonatal infectious diseases
- Pediatric neurology
- Microbiology
Background:
- Neonatal meningitis is a serious infection requiring prompt diagnosis and treatment.
- Escherichia coli K1 is a common causative agent of neonatal meningitis.
- Recurrent meningitis poses significant treatment challenges.
Observation:
- A preterm male infant (32 weeks' gestational age) presented with recurrent apnea on day 2 of life.
- The infant was diagnosed with Escherichia coli K1 antigen meningitis.
- A relapse of meningitis occurred 6 days after initial systemic and intrathecal antibiotic therapy.
Findings:
- Initial treatment included systemic gentamicin and chloramphenicol, plus intrathecal gentamicin.
- The relapsed meningitis was successfully treated with intraventricular gentamicin and systemic cotrimoxazole.
- This case underscores the potential for treatment failure and relapse in neonatal meningitis.
Implications:
- A high index of suspicion for meningitis is crucial in the newborn period.
- Adequate treatment of accompanying ventriculitis is essential for successful outcomes.
- Novel therapeutic strategies may be required for resistant or relapsed neonatal meningitis cases.