Neonatal meningococcal conjunctivitis associated with meningococcal meningitis.

Ellis, Maxwell; Weindling, A M; Davidson, D C; Ho, Nhung Thi Hong; Damjanović, Vladimir

doi:10.1136/adc.67.10_spec_no.1219

Cited by 29 publications

(21 citation statements)

References 6 publications

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“…Despite the favorable evolution of this case, the literature shows, in the few existing reports, a high probability of neurological sequelae, and also the risk of neonatal death, regardless of the correct treatment 1,3,5 . Moreover, there have been reports of cerebral abscesses caused by meningococcal infection in the neonatal period 2 .…”

Section: Discussionmentioning

confidence: 83%

Neonatal sepsis and meningitis caused by Neisseria meningitidis: a case report

Falcão

Andrade

Ceccon

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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SUMMARYObjective: To report a full-term newborn infant that developed a sepsis associated to meningitis caused by Neisseria meningitidis serogroup C on the 14 th day of life. Case description: The patient was a term female infant, born to a mother with Systemic Lupus Erythematosus, with birth weight of 2,610g, Apgar Score 1, 4 and 8, who needed mechanical ventilation for 24 hours. On the 7 th day of life, the neonate was discharged from the hospital with good overall condition. On the 15 th day of life, the newborn infant presented fever and respiratory failure. The cerebrospinal fluid showed 1042 cells/mm³, with neutrophilic predominance, protein of 435 mg/dL, and glucose < 10 mg/dL. The blood and the cerebrospinal fluid cultures were positive for Neisseria meningitidis serogroup C. The neonate was hospitalized, needing mechanical ventilation and vasoactive drugs, and received 21 days of crystalline penicillin. After hospital discharge, there were no signs of neurological sequels and the infant was able to be breastfed.The case report presents a unique situation: an uncommon etiology of neonatal meningitis and favorable evolution, despite neurological sequels reported in the literature. This report emphasizes the need to prevent the premature exposure of newborn infants to pathological agents, especially if they presented birth injuries and/or are preterm, due to their lack of immunological capacity.

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Section: Discussionmentioning

confidence: 83%

Neonatal sepsis and meningitis caused by Neisseria meningitidis: a case report

Falcão

Andrade

Ceccon

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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“…6 Despite the favorable evolution of this case, the literature shows in the few existing reports a high probability of neurological sequelae, and also the risk of neonatal death, regardless of the correct treatment. [7][8][9] Moreover, there have been reports of cerebral abscesses caused by meningococcal infection in the neonatal period. 10 Sequelae occur in approximately 10% of patients with meningococcal meningitis, and permanent neurological deficits include hearing loss, 5 hydrocephalus, seizure disorders, speech disorders, and mental and motor disabilities.…”

Section: Discussionmentioning

confidence: 99%

Fulminant Meningococcemia with meningococcal meningitis in a neonate - A case report

Kumar

Yadav

Singh

et al. 2014

Int J Contemp Pediatr

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Although meningococcal meningitis is fairly common in children, in neonate, it is rare with systemic involvement presumably because of transplacental passage of protective maternal antibodies. The diagnosis depends on a combination of clinical examination, including fever, refusal to feed, convulsions and the typical rash, and pathological and microbiological confirmation of the disease. Outcome of the disease may be fatal if timely intervention not done. In the literature, very few cases of neonatal meningococcal disease have been reported in the India. We are reporting a 14-day-old neonate who developed meningococcemia with meningococcal meningitis on the 9 th day of life, evolving to septic shock. The blood and the cerebrospinal fluid cultures were positive for Neisseria meningitidis. The meningococcemia should be suspected as a cause of cutaneous petechiae and purpura in neonates having signs of septicemia as early identification and management of meningococcemia with meningitis in the neonate can be life-saving.

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“…24,25 Meningitis may develop following intracranial invasion of organisms from a contiguous extracranial source or, more commonly, as a result of hematogenous spread from a distant focus of infection. 26,27 Typically, brain abscesses arising from parameningeal foci are single and are located in the temporal or frontal lobes, whereas those arising from distant foci are multiple and occur widely throughout the brain.…”

Section: Discussionmentioning

confidence: 99%

Bacteremia, Meningitis, and Brain Abscesses in a Hospitalized Infant: Complications of Pseudomonas aeruginosa Conjunctivitis

1999

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This report describes a preterm infant hospitalized in a neonatal intensive care unit who developed Pseudomonas aeruginosa conjunctivitis associated with bacteremia, meningitis, and multiple brain abscesses. P. aeruginosa conjunctivitis can rapidly progress to an invasive eye infection, such as corneal ulceration or endophthalmitis, leading to poor vision or blindness. Progression of this infection may lead to systemic disease. However, as illustrated in this report, P. aeruginosa conjunctivitis may be associated with the development of systemic complications such as bacteremia and meningitis in the absence of invasive eye disease. P. aeruginosa is a relatively common cause of conjunctivitis in hospitalized preterm and low birth weight infants. Given the severity of the ocular and systemic complications of Pseudomonas conjunctivitis, clinicians are reminded that prompt detection and treatment of neonatal conjunctivitis is critical. CASE REPORTAn infant boy was born by cesarean section at 27 weeks' gestation due to a prolapsed umbilical cord. The infant's birth weight was 910 gm, and Apgar scores were 5 and 6 at 1 and 5 minutes, respectively. The infant required mechanical ventilation for treatment of respiratory distress syndrome for the first 11 days of life. On day 12 of life, a purulent conjunctivitis of the right eye was noted and a conjunctival bacterial culture was obtained.On day 13 of life, the infant developed signs and symptoms of septic shock. Physical exam was remarkable for a heart rate of 220 beats per minute, respirations at 40 to 50/min, and blood pressure at 30/20 mm Hg. The infant was lethargic but had normal upper and lower extremity tone. The anterior fontanelle was flat. There was decreased perfusion with cold extremities and delayed capillary refill. This deterioration was accompanied by metabolic acidosis. The white blood cell count was 50,900/mm 3 with 59% segmented neutrophils and 17% band forms. The platelet count was 20,000/mm 3 , and prothrombin and partial thromboplastin times were prolonged at 26.5 seconds and Ͼ2 minutes, respectively. Cerebrospinal fluid examination revealed a glucose of 22 mg/dl, a protein of 164 mg/dl, 5/mm 3 erythrocytes, and 387/mm 3 leukocytes. Blood, urine, endotracheal secretion, and cerebrospinal fluid cultures were obtained. Cranial ultrasonography was normal. Treatment included intravenous fluid boluses, dopamine infusion, mechanical ventilation, and transfusion with packed red blood cells, fresh frozen plasma, and platelets. Intravenous ampicillin and ceftriaxone were prescribed. These were subsequently changed to intravenous gentamicin and ceftazidime when Pseudomonas aeruginosa was isolated from blood, endotracheal, and conjunctival cultures. Both eyes were treated with ophthalmic gentamicin ointment.The infant's condition remained poor over the next week. Although his conjunctivitis had resolved, he was still lethargic with poor perfusion. He continued to require mechanical ventilation and pressor support as well as multiple packed red blood cell, pla...

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Neonatal meningococcal conjunctivitis associated with meningococcal meningitis.

Cited by 29 publications

References 6 publications

Neonatal sepsis and meningitis caused by Neisseria meningitidis: a case report

Neonatal sepsis and meningitis caused by Neisseria meningitidis: a case report

Fulminant Meningococcemia with meningococcal meningitis in a neonate - A case report

Bacteremia, Meningitis, and Brain Abscesses in a Hospitalized Infant: Complications of Pseudomonas aeruginosa Conjunctivitis

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