A Case Report on Biot's Breathing: An Early Sign of Brainstem Dysfunction in Neonatal Bacterial Meningitis

Neonatal seizures are a diagnostic challenge that requires urgent identification of the underlying etiology. We present the case of a 16-day-old newborn admitted with afebrile seizures and severe hyponatremia, in whom further investigation revealed Escherichia coli bacterial meningitis complicated by syndrome of inappropriate antidiuretic hormone secretion (SIADH), post-infectious hydrocephalus, and Biot's breathing. This case highlights the complexity of neonatal seizure evaluation when initial clinical findings are misleading and emphasizes the value of recognizing Biot's breathing as an early clinical sign of brainstem dysfunction in the context of neonatal bacterial meningitis, warranting prompt, multidisciplinary management.