MENINGITA NEONATALĂ CU ESCHERICHIA COLI K1. PREZENTARE DE CAZ.

Introduction: Neonatal meningitis is an uncommon pathology with high morbidity and mortality. In industrialised countries the most frequent pathogen involved is group B Streptococcus, while in underdeveloped nations neonatal meningitis is more commonly caused by Gram negative pathogens. Case presentation: A 9 days old newborn girl was admitted to our clinic with fever starting two days prior to presentation, initially treated at home with antipyretics. Personal and family history were unremarkable. Clinical examination showed an influenced general condition and a parieto-occipital cefalhematoma, no bulging fontanelle. Inflammatory markers were positive (CRP>300 mg/l) and the cerebrospinal fluid (CSF) examination showed increased proteins (2.170mg/l) and leucocytes (9216/μl) and decreased glucose (7 mg/dl). Empiric antibiotic treatment with Ceftriaxone and Ampicillin was initiated for the suspected diagnosis of bacterial meningitis. CSF cultures were positive for Escherichia Coli K1 and the antibiotic treatment was changed to Ceftriaxone, Gentamicin and Ampicilin/Clavulanic acid, according to the antibiogram. Hemocultures were negative. The patient presented fever for 3 days under antibiotic treatment. The control lumbar puncture showed a marked decrease in proteins and leucocytes and an increase in glucose, no bacterial growth. Clinical and paraclinical control after 4 weeks showed no signs of infection and no complications. Conclusions: Neonatal meningitis may occur in newborns without predisposing factors. Lumbar puncture and CSF examination is mandatory in case of fever in the neonatal period, regardless of the clinical aspect. [ABSTRACT FROM AUTHOR]