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Bacteremia in a Newborn with Hypocalcemic Seizures and Vitamin D Deficiency

Rebecca L Moore1,2,3, Matthew L Lorenz1,2,3, Meghan E Fredette1,4

  • 1Department of Pediatrics, Brown University, Providence, RI, USA.

Case Reports in Endocrinology
|July 1, 2021
PubMed

Insights

Neonatal hypocalcemia seizures in newborns can signal sepsis. A case of late-onset seizures linked to Vitamin D deficiency and Klebsiella pneumoniae bacteremia underscores the need for sepsis evaluation in infants with hypocalcemic seizures.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Infectious Diseases

Background:

  • Neonatal hypocalcemia, a common cause of seizures in infants, can arise from parathyroid (PTH) insufficiency or resistance.
  • Elevated PTH levels in hypocalcemia suggest causes like vitamin D deficiency (VDD), renal dysfunction, hypomagnesemia, or critical illness.
  • Hypocalcemia is also recognized as a complication of Gram-negative bacteremia and sepsis in adults.

Observation:

  • A full-term, formula-fed newborn experienced late-onset hypocalcemic seizures.
  • The infant was diagnosed with Vitamin D deficiency (VDD).
  • The hypocalcemia and VDD occurred concurrently with Klebsiella pneumoniae bacteremia.

Findings:

  • This case demonstrates a direct link between Klebsiella pneumoniae bacteremia, Vitamin D deficiency, and hypocalcemic seizures in a newborn.
  • The presentation suggests that sepsis can precipitate or exacerbate hypocalcemia in neonates, even with underlying VDD.

Implications:

  • Newborns presenting with hypocalcemic seizures warrant a thorough evaluation for sepsis.
  • Early identification and treatment of sepsis are crucial in neonates with hypocalcemia to prevent severe neurological complications.
  • This case highlights the importance of considering infectious etiologies in the differential diagnosis of neonatal hypocalcemia.

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