Cerebral Abscess Complicating Proteus mirabilis Meningitis in a Newborn Infant

Phan, Helen; Lehman, Deborah

doi:10.1177/0883073811422271

Cited by 20 publications

(15 citation statements)

References 11 publications

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“…There are several species of Proteus, but Proteus mirabilis and Proteus vulgaris are more common among clinical isolates. It is the causative organism of urinary tract infections, osteomyelitis, mastoiditis and wound infection as well as neonatal gram-negative meningitis with an incidence of 4% (8). As a complication, intracranial abscess has an increased risk of neurologic sequelae, developmental delay, visual and audiologic impairment or death (9).…”

Section: Discussionmentioning

confidence: 99%

A newborn with hemorrhagic meningoencephalitis due to Proteus mirabilis

Coskun

Akman

Yıldırım

et al. 2016

DD&T

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Section: Discussionmentioning

confidence: 99%

A newborn with hemorrhagic meningoencephalitis due to Proteus mirabilis

Coskun

Akman

Yıldırım

et al. 2016

DD&T

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“…Brain abscesses were found when the imaging was performed at least a week after disease onset. The finding of a brain abscess on brain MRI imaging on initial anti biotic use 4) , seizure occurs 7) , or when the antibiotics do not match the culture sensitivities 2) . For our patient, we chose cefotaxime and vancomycin as initial antibiotic empirical treatment for bacterial meningitis.…”

Section: Introductionmentioning

confidence: 99%

“…Two cases involved serial imaging 4,7) , but this was not possible in other cases because the patients had died. In the case reported by Phan and Lehman, the initial brain CT performed 7 days after the onset of symptoms revealed a left frontal cavitary lesion.…”

Section: Introductionmentioning

confidence: 99%

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Case Report of Neonatal Proteus mirabilis Meningitis and Brain Abscess with Negative Initial Image Finding: Consideration of Serial Imaging Studies

Chung¹,

Kim²,

Han³

et al. 2017

Neonatal Med

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Proteus mirabilis (P. mirabilis) meningitis in a neonate is rare, but its recognition is important because the disease progresses rapidly and has poor prognosis. A 4-dayold premature female infant born at 36 weeks and 5 days of gestation presented with symptoms of fever and icteric skin. Initial cerebrospinal fluid findings suggested bacterial meningitis, and treatment with antibiotics was started. On the third day, P. mirabilis growth was found in both blood and cerebrospinal fluid cultures and brain computed tomography revealed normal findings. The patient showed improved clinical symptoms, but brain magnetic resonance imaging on hospital day 18 revealed a brain abscess measuring 4.5×3.1×3.1 cm in the right frontal lobe. Cyst drainage was performed immediately and a catheter was inserted. Follow-up computed tomography revealed a tiny abscess remaining in the right frontal lobe, and follow-up magnetic resonance imaging later demonstrated marked interval regression in the size of the abscess. The patient was discharged on day 57 of hospitalization in good condition. Serial brain imaging should be considered in neonatal cases of P. mirabilis meningitis.

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“…Route of infection has not been established but presumed to be ascending infection during delivery due to its early presentation. In most of the cases reported in literature, the course of the infection appears to be fatal involving severe neurological complication with cerebral abscess and pneumocephalus formation despite institution of appropriate antibiotics [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Proteus Mirabilis Septicemia and Meningitis in a Neonate

Omoruyi

2014

J Med Cases

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A 6-day-old premature baby boy presented in a pediatric clinic for severe jaundice, poor feeding and lethargy. He was born to a 24-year-old mother who was primigravida. Pregnancy was complicated by gestational diabetes, appropriately treated chlamydial infection, oligohydramnios and inadequate prenatal care. On physical examination, he was hypotonic and irritable with significant jaundice seen from his head to his lower extremities. Transcutaneous bilirubin obtained in clinic showed a level of 14 mg/dL. A serum bilirubin level was immediately ordered and it confirmed an elevated unconjugated bilirubin level of 18.9 mg/dL. He was admitted to the inpatient unit and a full septic work-up was initiated. Appropriate antibiotics were administered to cover for the most common pathogen involved in neonatal sepsis. A few hours into the admission, his condition deteriorated requiring intubation for multiple consecutive apneic episodes and seizure-like activity. Initial laboratory evaluation included an abnormal white blood cell count of 2,600/µL with left shift, elevated lactic acid of 9 mmol/L and a low bicarbonate level of 16 mmol/L further confirming acidosis. Analysis of cerebrospinal fluid revealed a white blood cell count of > 300/µL, low glucose with a level of 7 mg/dL and elevated protein level of 645 mg/dL. Due to his rapid clinical deterioration a few hours into the admission, a computed tomography scan of the brain was obtained. Computed tomography scan of brain showed significant damage to brain parenchyma consistent with anoxic brain injury. He expired on his second day of admission. Proteus mirabilis was the causative agent.

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Cerebral Abscess Complicating Proteus mirabilis Meningitis in a Newborn Infant

Cited by 20 publications

References 11 publications

A newborn with hemorrhagic meningoencephalitis due to <i>Proteus mirabilis </i>

A newborn with hemorrhagic meningoencephalitis due to <i>Proteus mirabilis </i>

Case Report of Neonatal Proteus mirabilis Meningitis and Brain Abscess with Negative Initial Image Finding: Consideration of Serial Imaging Studies

Proteus Mirabilis Septicemia and Meningitis in a Neonate

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