Cerebral abscess caused by Serratia marcescens in a premature neonate

Abstract

-Background: Cerebral abscesses are extremely rare in neonates. Serratia marcescens is an unusual cause of sepsis and neurological spread is especially ominous. Purpose: To report the case of a 34-week neonate who developed this rare condition and to discuss diagnostic and therapeutic measures. Case report: A 34-week male neonate sequentially developed respiratory distress syndrome, early sepsis and necrotizing enterocolitis; later cultures revealed S. marcescens. After deterioration, a cerebral abscess became evident, which revealed S. marcescens. Clinical improvement ensued after high-dose amikacin and meropenem. Conclusion: Clinical signs are often non-specific. Proper diagnostic measures, neurosurgical consultation and aggressive antibiotic therapy are essential for these high-risk neonates.KEY WORDS: brain abscess, infant, premature, intensive care, neonatal, meningoencephalitis, Serratia marcescens. Abscesso cerebral causado por Serratia marcescens em prematuroRESUMO -Introdução: Abscessos cerebrais são extremamente raros em neonatos. Serratia marcescens é causadora incomum de sepse nestes pacientes e a disseminação no sistema nervoso central é grave. Objetivo: Relatar um prematuro de 34 semanas que desenvolveu esta condição e discutir as medidas diagnósti-cas e terapêuticas. Relato de caso: Prematuro masculino de 34 semanas desenvolveu síndrome do desconforto respiratório, sepse neonatal e enterocolite necrotizante; hemoculturas revelaram S. marcescens. Após deterioração clínica, evidenciou-se um abscesso cerebral cuja drenagem revelou S. marcescens. Houve melhora após introdução de amicacina e meropenem. Conclusão: Os sinais clínicos são inespecíficos. Passos diagnósticos apropriados, avaliação neurocirúrgica precoce e antibioticoterapia agressiva são essenciais para estes prematuros.

Intracranial complications of Serratia marcescens infection in neonates

“…[7,8] In our unit, three babies on whom cerebrospinal fluid (CSF) analysis had not been done died within 24 hours of onset of illness. Of the two survivors we describe, one had abnormal CSF analysis results of high protein, pleiocytosis and no organisms on culture, while the other had normal CSF results on two separate occasions.…”

Microbiologically Contaminated and Over-Preserved Cosmetic Products According Rapex 2008–2014

“…S. marcescens was generally considered non-pathogenic for humans [40], but since the 1950s has become an important cause of nosocomial infection [41]. Infants are at the greatest risk of S. marcescens infection (severe septicemia) or colonization [42][43][44][45]. Baby death has been reported from S. marcescens meningitis and septicemia after use of contaminated baby shampoo [46].…”

Pyogenic brain abscess caused by Serratia marcescens in a Brazilian premature neonate

“…Most patients have a demonstrable infectious source leading to the intracranial suppuration and chronic otitis media has been found as the main source of microorganism in most cases and streptococci seems to be the most common agent isolated from cultures of the purulent material obtained during surgical drainage 1,5,6,16,26 . However, brain abscess in premature neonates is a rare condition and few reports exist in English literature pointing Serratia marcescens as the causative agent 4,14,21 .…”

“…in most international series 5,16,26 . However, brain abscess has been rarely described in preterm newborns and few reports exist on English medical literature pointing Serratia marcescens as the causative agent on those high-risk pediatric patients 4,14,21 .…”