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Relapsing E. coli K1 antigen meningitis in a newborn
Abstract:
A male infant of 32 weeks' gestational age who presented with recurrent apnoea on the second day of life was shown to have an Escherichia coli K1 antigen meningitis. Relapse occurred 6 days after an adequate systemic course of gentamicin and chloramphenicol and intrathecal gentamicin. This was successfully treated with intraventricular gentamicin and systemic cotrimoxazole. The need to maintain a high index of suspicion for meningitis in the newborn period and to treat adequately the frequently accompanying ventriculitis is emphasized.
Insights
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.