Purulent Bacterial Meningitis at Birth

Document Type : Case Report


1 Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran

2 Fellowship of NICU, Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran

3 Bachelor of Science in Nursing (BSN), Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran


Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, which are known as the meninges. This infection may be caused by Streptococcus pneumonia bacteria. In this study, we presented the case of a female newborn with meningitis secondary to Streptococcus pneumonia. Her birth weight and height were normal. After 24 hours of birth, the neonate was diagnosed with tachypnea, without presenting any signs of fever or respiratory distress. The newborn was referred to Sheikh Children's Hospital, where chest X-ray showed clear lungs with no evidence of abnormality. Furthermore, the cardiothoracic ratio was normal. A complete blood count demonstrated white blood cell (WBC) count of 5400/uL. In Blood/Culcture ratio (B/C) test, Streptococcus pneumonia was reported, and the results of the cerebrospinal fluid (CSF) analysis confirmed this result. Following 14 days of receiving antibiotic therapy, the results of CSF analysis were within the normal range. Her visual and hearing examinations were normal, and demonstrated improved situation. The infant was discharged with exclusive breastfeeding.


1.   Saez-Llorens X, McCracken GH Jr. Bacterial meningitis in children. Lancet. 2003; 361(9375):2139-48.
2.   Polin RA, Harris MC. Neonatal bacterial meningitis. Seminars in neonatology. Semin Fetal Neonatal 2001; 6(2):157-72.
3.   Spanos A, Harrell FE Jr, Durack DT. Differential diagnosis of acute meningitis: An analysis of the predictive value of initial observations. JAMA. 1989; 262(19):2700-7.
4.   Giorgi Rossi P, Mantovani J, Ferroni E, Forcina A, Stanghellini E, Curtale F, et al. Incidence of bacterial meningitis (2001-2005) in Lazio, Italy: the results of a integrated surveillance system. BMC Infect Dis. 2009; 9:13.
5.   Bas AY, Demirel N, Aydin M, Zenciroglu A, Tonbul A, Tanir G. Pneumococcal meningitis in the newborn period in a prevaccination era: a 10-year experience at a tertiary intensive care unit. Turk J Pediatr. 2011; 53(2):142-8.
6.   Balliu Badia PR, Reina Prieto J, Armillas Oliveros JC, Moreno Galdo A, Borrell Sole N, Simonet Salas JM. [Neonatal sepsis caused by Streptococcus pneumoniae. Report of two cases]. An Esp Pediatr. 1992; 36(2):145-7.
7.   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.
8.   Hughes BR, Mercer JL, Gosbel LB. Neonatal pneumococcal sepsis in association with fatal maternal pneumococcal sepsis. Aust N Z J Obstet Gynaecol. 2001; 41(4):457-8.
9.   Harvey D, Holt DE, Bedford H. Bacterial meningitis in the newborn: a prospective study of mortality and morbidity. Semin Perinatol. 1999; 23(3):218-25.
10. Andersen CO. Streptococcus penumoniae meningitis. Clinical and experimental studies. Dan Med Bull. 2007; 54(3):189-209.