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Neonatal enterobacter suppurative arthritis and osteomyelitis
Helvetica Paediatrica Acta
|January 1, 1981
Summary
A neonatal urinary tract infection caused by cephalosporin-sensitive Enterobacter progressed to resistant sepsis in the knee and femur. Treatment with gentamicin and co-trimoxazole was successful, highlighting the need to consider gram-negative bacteria in infant osteoarticular infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatric Orthopedics
Background:
- Posterior urethral valves can cause urinary tract infections (UTIs) in neonates.
- Enterobacter species are a potential cause of neonatal UTIs.
- Osteoarticular infections in infants can be severe and require prompt diagnosis.
Observation:
- An 18-day-old infant with a posterior urethral valve developed a UTI caused by cephalosporin-sensitive Enterobacter.
- The infant subsequently developed suppurative arthritis of the knee and osteomyelitis of the femur.
- Cephalosporin-resistant Enterobacter was isolated from urine and knee joint fluid after initial therapy.
Findings:
- The neonatal osteoarticular infection and UTI were successfully treated with a combination of gentamicin and co-trimoxazole.
- This case demonstrates the rapid development of antibiotic resistance in Enterobacter during treatment.
- Gram-negative bacteria, particularly Enterobacter, should be suspected in neonatal osteoarticular infections, especially with concurrent UTIs.
Implications:
- Early recognition and appropriate antibiotic selection are crucial for managing neonatal gram-negative bacterial infections.
- The potential for rapid development of antibiotic resistance necessitates careful monitoring and potential combination therapy.
- This case underscores the importance of considering urinary tract abnormalities in neonates presenting with severe infections.