Relapse of Neonatal Escherichia coli Meningitis: Did We Miss Something at First?
Open Access
- 10 February 2021
- Vol. 8 (2), 126
- https://doi.org/10.3390/children8020126
Abstract
Relapse of neonatal meningitis is most commonly caused by Escherichia coli. Management to prevent relapse varies and evidence is limited. We present four cases of relapsing neonatal E. coli meningitis in Denmark in 2016–2017 and review the current literature on this subject. During the primary episodes, our patients received cephalosporin for 3 weeks and gentamicin for the first 3 days. The only identified risk factor was delayed CSF sterilization in three of four cases and no repeated lumbar puncture. Relapse occurred after 2–28 days; one case with ventriculitis and one with empyema. Relapses were treated for 6–14 weeks with monotherapy. No children had an underlying disease predisposing to E. coli meningitis. There is generally a trend towards reducing invasive procedures, e.g., lumbar puncture and the length of intravenous antibiotics in pediatric infectious diseases, but our cases highlight a condition where the opposite might be needed.Keywords
This publication has 12 references indexed in Scilit:
- Combination therapy with ciprofloxacin and third-generation cephalosporin versus third-generation cephalosporin monotherapy in Escherichia coli meningitis in infants: a multicentre propensity score–matched observational studyClinical Microbiology & Infection, 2018
- The Epidemiology, Management, and Outcomes of Bacterial Meningitis in InfantsPEDIATRICS, 2017
- Escherichia ColiMeningitis Features in 325 Children From 2001 to 2013 in FranceClinical Infectious Diseases, 2015
- Repeat lumbar punctures in infants with meningitis in the neonatal intensive care unitJournal of Perinatology, 2010
- Epidemiology, Etiology, Pathogenesis, and Diagnosis of Recurrent Bacterial MeningitisClinical Microbiology Reviews, 2008
- Neonatal meningitisArchives of Disease in Childhood: Fetal & Neonatal, 2003
- Should repeat lumbar punctures be routinely done in neonates with bacterial meningitis? Results of a survey into clinical practiceArchives of Disease in Childhood, 2001
- Gram-negative enteric bacillary meningitis: A twenty-one-year experienceThe Journal of Pediatrics, 1993
- Neonatal Gram negative meningitis: A 10‐year review, with reference to outcome and relapse of infectionJournal of Paediatrics and Child Health, 1990
- Recrudescence and Relapse in Bacterial Meningitis of ChildhoodPEDIATRICS, 1981