Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First?
Relapse of neonatal meningitis is most commonly caused by <i>Escherichia coli</i>. Management to prevent relapse varies and evidence is limited. We present four cases of relapsing neonatal <i>E. coli</i> meningitis in Denmark in 2016–2017 and review the current literature on...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/8/2/126 |
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| author | Nadja H. Vissing Mette B. Mønster Sannie Nordly Gholamreza K. Dayani Sofie S. Heedegaard Jenny D. Knudsen Ulrikka Nygaard |
| author_facet | Nadja H. Vissing Mette B. Mønster Sannie Nordly Gholamreza K. Dayani Sofie S. Heedegaard Jenny D. Knudsen Ulrikka Nygaard |
| author_sort | Nadja H. Vissing |
| collection | DOAJ |
| description | Relapse of neonatal meningitis is most commonly caused by <i>Escherichia coli</i>. Management to prevent relapse varies and evidence is limited. We present four cases of relapsing neonatal <i>E. coli</i> 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 <i>E. coli</i> 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. |
| first_indexed | 2024-03-09T04:52:29Z |
| format | Article |
| id | doaj.art-ed92a13953b94513a6f8136194f1d81b |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T04:52:29Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-ed92a13953b94513a6f8136194f1d81b2023-12-03T13:10:03ZengMDPI AGChildren2227-90672021-02-018212610.3390/children8020126Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First?Nadja H. Vissing0Mette B. Mønster1Sannie Nordly2Gholamreza K. Dayani3Sofie S. Heedegaard4Jenny D. Knudsen5Ulrikka Nygaard6Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Pediatrics and Adolescence, Copenhagen University Hospital, 2650 Hvidovre, DenmarkDepartment of Pediatrics and Adolescence, Zealand University Hospital, 4000 Roskilde, DenmarkDepartment of Pediatrics and Adolescence, Herning Hospital, 7400 Herning, DenmarkDepartment of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkRelapse of neonatal meningitis is most commonly caused by <i>Escherichia coli</i>. Management to prevent relapse varies and evidence is limited. We present four cases of relapsing neonatal <i>E. coli</i> 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 <i>E. coli</i> 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.https://www.mdpi.com/2227-9067/8/2/126neonatemeningitis<i>E. coli</i>lumbar puncture |
| spellingShingle | Nadja H. Vissing Mette B. Mønster Sannie Nordly Gholamreza K. Dayani Sofie S. Heedegaard Jenny D. Knudsen Ulrikka Nygaard Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First? Children neonate meningitis <i>E. coli</i> lumbar puncture |
| title | Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First? |
| title_full | Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First? |
| title_fullStr | Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First? |
| title_full_unstemmed | Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First? |
| title_short | Relapse of Neonatal <i>Escherichia coli</i> Meningitis: Did We Miss Something at First? |
| title_sort | relapse of neonatal i escherichia coli i meningitis did we miss something at first |
| topic | neonate meningitis <i>E. coli</i> lumbar puncture |
| url | https://www.mdpi.com/2227-9067/8/2/126 |
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