Neonatal meningitis caused by streptococcus pneumonia in Iran

Document Type : Case Report

Authors

1 resident of community medicine

2 neonatalogist

3 Student of biology, Microbial biotechnology,Biology Departement, Faculty of science, Ferdowsi university, Mashhad, Iran

4 Imam zaman hospital, Department of pediatrics, Mashhad university of medical science, Mashhad, Iran

Abstract

Meningitis, pneumonia, and sepsis in newborns and young infants (age < 60 days) are the main causes of childhood mortality in developing countries. Even though streptococcus pneumonia is the most commonly detected microorganism in pediatric bacterial meningitis, it is rare in newborn infants. The following article reports a case of pneumococcal meningitis that was detected early in a newborn infant in 2013. A female baby was born by vaginal delivery with a birth weight of 2900 grams. She was symptomatic (poor feeding) from her first day of life, but she was admitted with a toxic status (dehydrated, lethargic, cyanotic, hypo tone, hypo reflex) to our referral center on her third day life. Her blood culture showed no growth of any organism and her urine culture was also negative, but the Cerebrospinal fluid (CSF) culture showed growth of streptococcus pneumonia. The maternal sepsis workup was normal. Despite all therapeutic management, unfortunately, the patient died on her fourth day after admission.

Keywords


  1. Mwaniki M K, Talbert AW, Njuguna P, English M, Were E, Lowe BS, et al. Clinical indicators of bacterial meningitis among neonates and young infants in rural Kenya. BMC Infectious Diseases. 2011; 11(301):1-10
  2. Amer MZ, Bandey M, Bukhari A, Nemenqani D. Neonatal meningitis caused by Elizabeth kingia meningoseptica in Saudi Arabia. J Infect Dev Ctries. 2011; 5(10):745-7.
  3. Harvey D, Holt D E, Bedford H. Bacterial meningitis in the newborn: a prospective study of mortality and morbidity. Semin perinatol. 1999; 3(23):218-25.
  4. Cha´vez-Bueno S, McCracken GH. Bacterial Meningitis in Children. Pediatr Clin North Am. 2005; 2(3):795– 810
  5. Sáez-Llorens X, McCracken GH.Bacterial meningitis in children. Lancet. 2003;321:2139-48.
  6. Bas AY, Demirel N, Aydin M, Zenciroglu N, Tonbul A, Tanir G. Pneumococcal meningitis in the newborn period in a prevaccination era: a 10-year experience at a tertiary intensive care unit. The Turkish journal of pediatrics. 2011;53(2):142-8.
  7. Jefferson T, Ferroni E, curtale F, Giorgi Rossi P, Borgia P. Streptococcus pneumonia in Western Europe: serotype distribution and incidence in children less than 2years old. Lancet Infect Dis. 2006;6(7):405-10.
  8. Giorgi Rossi PMantovani JFerroni EForcina AStanghellini ECurtale F, et al. Incidence of bacterial meningitis (2000-2005) in Lazio,Italy: the results of a integrated surveillance system. BMC Infect Dis. 2009;9:13.
  9. Singh J, Dick J, Santosham M. Colonization of the female urogenital tract with streptococcus pneumoniae and implications for neonatal disease. Pediatr infect Dis J. 2000;19(3):260-2.

10. Hanghes BR, Mercer JL, Gosbel LB. Neonatal pneumococcal sepsis in association with fatal maternal pneumococcal sepsis. Aust N Z J obstet Gynecol. 2001;41(4):457-8.

  1. 11.  Gomez M, Alter S, Kumar Ml, Murphy S, Rathore MH. Neonatal streptococcus pneumonia infection:case reports and review of the literature. Pediatr infect dis J. 1999;18(11):1014-8.

12. Heffelfinger JDDowell SFJorgensen JHKlugman KPMabry LRMusher DM, et al. Management of community-acquired pneumonia in the era of pneumococcal resistance: a report from the drug resistant streptococcus pneumonia therapeutic working group. Arch Intern Med 2000;160(10):1399-408.

  1. 13.  Klein JO, Marey MS. Bacterial sepsis and meningitis. In: Remington JS, Klein JO, editors. Infectious diseases of the fetus newborn infant. 4t ed. Philadelphia: WB saunders;1995.P.835-8.

14. Nel E. Neonatal meningitis: mortality, cerebrospinal fluid and microbiological findings. J trop pediatr. 2000;46(4):237-9.

15. Klinger G, Chin CN, Beyene J, Perlman M. Predicting the outcome of neonatal bacterial meningitis. Pediatrics. 2000;106(3):477-82.