Elizabethkingia meningoseptica are Gram-negative rod bacteria which are commonly found in the environment. The bacteria have also been associated with
nosocomial infections, having been isolated on contaminated medical equipment, especially in neonatal wards.
CASE REPORT: Here, we present the case of a premature female infant born at 33 weeks' gestational age, with neonatal
meningitis. The onset was marked by
fever, in the 5th day of life, while in the Neonatal Intensive Care Unit. The patient was commenced on
Gentamicin and
Ampicillin, but her clinical condition worsened.
Psychomotor agitation and food refusal developed in the 10th day of life, and a diagnosis of
bacterial meningitis was made based on clinical and cerebrospinal fluid findings. A strain of Elizabethkingia meningoseptica sensitive to
Vancomycin,
Rifampicin and
Clarithromycin was isolated from cerebrospinal fluid. First-line
antibiotic therapy with
Meropenem and
Vancomycin was adjusted by replacing Meronem with
Piperacillin/Tazobactam and
Rifampicin. The patient's clinical condition improved, although some isolated febrile episodes were still present. The cerebrospinal fluid was normalized after 6 weeks of
antibiotic treatment, although periventriculitis and tetraventricular
hydrocephalus were revealed by imaging studies. Neurosurgical drainage was necessary.
CONCLUSION: Elizabethkingia meningoseptica can cause severe
infection, with high risk of mortality and neurological sequelae in neonates.
Intensive care and multidisciplinary interventions are crucial for case management.