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Neonatal meningococcal meningitis: report of two cases
1Department of Pediatrics, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Abstract:
Two neonates with meningococcal meningitis and meningococcemia are reported. The two, aged 28 and 16 days, respectively, presented similar symptoms of fever, poor appetite and poor activity. Both blood and cerebrospinal fluid cultures of each patient grew Neisseria meningitidis. The isolated bacteria were sensitive to penicillin, and both patients recovered completely after penicillin treatment for 22 and 15 days, respectively. In the antibiotic era, only 22 cases of neonatal meningococcal meningitis have been reported in the English literature. Among these reports, at least 7 patients survived without sequelae; 6 of those were treated with different combinations of antibiotics, including penicillin, for variable durations of 7-14 days. Therefore, effective antibiotic therapy for 14 days should be adequate in the treatment of uncomplicated neonatal meningococcal meningitis and meningococcemia.
Insights
Two neonates with meningococcal meningitis and meningococcemia recovered fully with penicillin treatment. A 14-day penicillin course appears adequate for uncomplicated cases in neonates.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Bacteriology
Background:
- Meningococcal disease (Neisseria meningitidis) is rare in neonates.
- Neonatal meningitis and meningococcemia present with non-specific symptoms like fever and poor activity.
Observation:
- Two neonates, aged 28 and 16 days, presented with symptoms of fever, poor appetite, and poor activity.
- Blood and cerebrospinal fluid cultures confirmed Neisseria meningitidis in both patients.
Findings:
- The Neisseria meningitidis isolates were sensitive to penicillin.
- Both neonates achieved complete recovery following penicillin therapy (22 and 15 days).
- Literature review indicates 14-day antibiotic courses are often sufficient for neonatal cases.
Implications:
- Penicillin is an effective treatment for neonatal meningococcal meningitis and meningococcemia.
- A 14-day antibiotic duration may be adequate for uncomplicated neonatal cases, potentially reducing treatment length.
- Further research into optimal treatment durations for neonatal meningococcal infections is warranted.