Myocarditis and Meningitis during Early Sepsis in a Neonate with Streptococcus pseudopneumoniae: A Case Report


1 1. Amirkabir Hospital, School of Medicine, Department of Pediatrics, Pediatric Cardiology, Arak University of Medical Sciences, Arak, Iran

2 Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran

3 Department of Neonatology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran

4 Department of Biostatistics, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran


Although myocarditis is uncommon in neonates, a wide variety of infectious pathogens can result in myocarditis, including viruses, bacteria, rickettsia, fungi, and protozoa. Viruses are most often the infectious disease found to cause acute myocarditis. On the other hand, bacterial myocarditis (BM) is an unusual cause of infectious myocarditis. BM is commonly seen in the context of sepsis or as part of a bacterial syndrome.
Streptococcus pseudopneumoniae has mostly been isolated from the respiratory tract specimens. This infection is not prevalent in neonates. In this case report, a 5-day-old male neonate was admitted with the signs of fever, jaundice, and poor feeding. Moreover, he was lethargic and hypotonic with reduced neonatal reflexes and obvious tachycardia.
Clinical and physical examinations were performed in addition to chest X-rays, echocardiography, cerebrospinal fluid (CSF) analysis, and other laboratory tests. The final diagnosis was confirmed as myocarditis and meningitis. The patient was treated with antibiotics and intravenous immunoglobulin (IVIG).
On the sixth day of hospitalization, fever of the neonate fever resolved. On the 24th day, the CSF analysis was normal and the CSF, as well as blood culture were negative. The patient was discharged on the 30th day in good general and physical condition. The subsequent echocardiography performed four months’ post-hospitalization was normal.


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