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Case Report: Prolonged CSF PCR Positivity in a Neonate With GBS Meningitis
Nourah Alruqaie1,2, Yara Falatah1, Fawaz Alzahrani1,3
1King Abdullah International Medical Research Centre, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia.
Abstract:
Bacterial meningitis is one of the critical diseases that needs to be diagnosed and treated promptly. Recent diagnostics of high sensitivity and specificity rates, such as PCR, helped with such presentation, especially in cases with prior antibiotics that led to culture negativity. However, the time window of PCR positivity is not well-studied, with scattered reports of different periods of positivity. Here, we report a case of neonatal GBS meningitis with positive PCR for more than 80 days from starting antibiotics.
Insights
Neonatal meningitis requires rapid diagnosis. Polymerase chain reaction (PCR) can detect bacterial DNA long after antibiotic treatment begins, as shown in a case lasting over 80 days.
Area of Science:
- Neonatal infectious diseases
- Clinical microbiology
- Molecular diagnostics
Background:
- Bacterial meningitis is a critical condition requiring prompt diagnosis and treatment.
- Polymerase chain reaction (PCR) offers high sensitivity and specificity, aiding diagnosis, especially when prior antibiotic use renders cultures negative.
- The duration of PCR positivity in bacterial meningitis is not well-established.
Observation:
- This report details a case of neonatal meningitis caused by Group B Streptococcus (GBS).
- The patient received antibiotic treatment for the infection.
- Cerebrospinal fluid (CSF) PCR remained positive for GBS DNA for over 80 days after the initiation of antibiotic therapy.
Findings:
- Prolonged PCR positivity in neonatal GBS meningitis can extend beyond 80 days despite antibiotic treatment.
- This extended duration challenges the interpretation of PCR results in guiding treatment duration or assessing eradication.
Implications:
- The findings suggest that PCR positivity alone may not be a reliable indicator of persistent infection or treatment failure in neonatal meningitis.
- Further research is needed to understand the kinetics of PCR positivity in relation to treatment response and clinical outcomes.
- Clinical correlation remains crucial for managing neonatal meningitis, even with advanced molecular diagnostic tools.
