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[Serratia marcescens brain abscess in a newborn]
1Department of Pediatrics, Asahikawa Kosei Hospital.
Summary
A premature infant developed Serratia marcescens meningitis and brain abscess, leading to hydrocephalus and neurological deficits. Despite treatment, the infant experienced seizures and developmental delay, highlighting the severity of neonatal S. marcescens infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatric Neurology
Background:
- Premature birth (35 weeks) complicated by fetal distress, transient tachypnea, and renal failure.
- Initial neonatal course improved after supportive care.
Observation:
- On day 7, lethargy and feeding intolerance developed, with cerebrospinal fluid (CSF) analysis showing 8,000 leukocytes/microliter.
- Blood and CSF cultures identified Serratia marcescens (S. marcescens).
Findings:
- Cranial CT revealed a left parietooccipital brain abscess and right-sided diffuse infarction.
- Recurrent CSF pleocytosis, elevated C-reactive protein (CRP), and clinical deterioration suggested abscess rupture into the lateral ventricle.
- Surgical drainage for hydrocephalus was performed on day 55; the abscess resolved by day 110.
Implications:
- Neonatal S. marcescens meningitis can lead to severe neurological sequelae, including brain abscess and infarction.
- Long-term outcomes included significant psychomotor delay (equivalent to a 2-year-old at age 3) and secondary epilepsy.
- This case underscores the critical need for prompt diagnosis and management of S. marcescens infections in neonates to mitigate severe neurological complications.