Case report: an infant with late-onset meningitis caused by Escherichia coli

Meningitis is highly prevalent in infant because their immune system is immature and they have less resistance to diseases. Among bacterial agents, Escherichia coli is recognized as one of the most important causes of meningitis in infants.

Herein, we report a case of late-onset meningitis, caused by E. coli (Patient:17-day-old female infant). The patient's body temperature was 39°C, and the initial diagnosis was sepsis. At the doctor's request, the patient underwent the basic tests and was hospitalized in the Neonatal Intensive Care Unit (NICU). In this case, blood culture and CSF culture were negative and positive, respectively. Echogenic particles were observed inside the bladder, indicating possible cystitis. The results of the antibiotic susceptibility tests showed that the meningitis-causing strain of E. coli was susceptible only to amikacin.

Conducting LP and CSF culture seems to be the most important strategy for diagnosing meningitis. It is also recommended to perform LP before taking antibiotics. For identifying the infection, some factors such as fever, CRP test results, CSF parameters (leukocyte count, glucose level, and CSF culture results) should be considered to prevent misdiagnosis.