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Pasteurella multocida meningitis in a two-day old neonate
S Hillery1, E A Reiss-Levy, C Browne
1Department of Microbiology, St. George Hospital, Kogarah, Australia.
Abstract:
A normal full-term baby boy, born by vaginal delivery, became ill on day 2 with fever and failure to feed. CSF examination revealed 260 x 10(6)/l leucocytes, mainly mononuclears, protein 2 g/l and glucose zero. Pasteurella multocida was isolated in pure culture from the baby's CSF, blood and umbilicus and from the mother's vagina. The baby was treated with i.v. penicillin for 7 weeks. Progress was complicated by mild hydrocephalus, which resolved, and prolonged low grade fever. Recovery was complete, without neurological sequelae. This case illustrates that P. multocida can infect the vagina where it presents a hazard to a newborn infant delivered vaginally. Early diagnosis is critical, intravenous high dose penicillin being the treatment of choice.
Insights
Pasteurella multocida vaginal infection poses a significant risk to newborns during vaginal delivery. Prompt diagnosis and intravenous penicillin treatment are crucial for complete recovery without neurological complications.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Neonatal infections can lead to severe complications.
- Vaginal delivery is a common route of transmission for certain pathogens.
- Pasteurella multocida is a bacterium that can cause various infections.
Observation:
- A full-term infant developed fever and feeding issues on day 2 postpartum.
- Cerebrospinal fluid (CSF) analysis showed elevated white blood cells (mononuclears), high protein, and zero glucose.
- Pasteurella multocida was identified in the infant's CSF, blood, and umbilical stump, as well as the mother's vagina.
Findings:
- The infant was diagnosed with Pasteurella multocida sepsis originating from vaginal colonization.
- Treatment involved 7 weeks of intravenous penicillin.
- The infant experienced mild hydrocephalus and prolonged fever, which resolved.
- Complete recovery was achieved with no neurological sequelae.
Implications:
- Maternal vaginal Pasteurella multocida colonization can pose a serious hazard to newborns during vaginal birth.
- Early and accurate diagnosis of neonatal infections is critical for effective management.
- High-dose intravenous penicillin is the recommended treatment for Pasteurella multocida infections in neonates.
- This case highlights the importance of considering less common pathogens in neonatal sepsis evaluations.