Open Access
CC BY 4.0 · Arq Neuropsiquiatr 2024; 82(S 02): S53-S176
DOI: 10.1055/s-0045-1806990
ID: 572
Area: Neuroinfections
Presentation method: Eletronic Poster

Neonatal meningitis and intracranial empyema due to Proteus mirabilis: a case report

Anna Jamylle Dias Borges Leal
1   Universidade Federal do Ceará, Complexo Hospitalar, Fortaleza CE, Brazil.
,
Rebeca Montalverne Barreto de Paula Pessoa
1   Universidade Federal do Ceará, Complexo Hospitalar, Fortaleza CE, Brazil.
,
Kathiane Moreira de Freitas Martins
1   Universidade Federal do Ceará, Complexo Hospitalar, Fortaleza CE, Brazil.
,
Gabrielle Gomes de Sousa
1   Universidade Federal do Ceará, Complexo Hospitalar, Fortaleza CE, Brazil.
,
Priscila Magalhães de Medeiros
1   Universidade Federal do Ceará, Complexo Hospitalar, Fortaleza CE, Brazil.
,
Claudiane Cavalcanti Pessoa Pascoal
1   Universidade Federal do Ceará, Complexo Hospitalar, Fortaleza CE, Brazil.
› Author Affiliations
 

    *Correspondence: jamylle_dias@hotmail.com.

    Abstract

    Case Presentation: Term Newborn, male, small for gestational age, born by cesarean delivery because of acute fetal distress and gastroschisis, was submitted to surgery immediately after birth on 01/14/23. On 01/27/23 the newborn was presented with hyperthermia and apnea, resulting in investigation for sepsis. Blood and liquor cultures were positive for Proteus mirabilis and sensitive to fourth generation cephalosporins. The baby was submitted to transfontanellar ultrasound, that showed signs of supratentorial ependymitis with ventriculomegaly on 02/02/23, causing the neonatologists to change the therapy for carbapenem and aminoglycoside. The patient, however, evolved with seizures, hyperthermia and apnea. On 03/03/23 was submitted to magnetic resonance imaging that showed empyemas in the middle and posterior cranial fossa. Medical assistant decided to continue the antimicrobial therapy and to not submit the baby to a surgery intervention. The baby evolved with negative cultures and with improvement of symptoms, with hospital discharge on 04/12/23 (3 months old).

    Discussion: Neonatal bacterial meningitis is a devastating infection, associated with many neurological complications, such as seizures, encephalopathy and intracranial empyema. The most common pathogens are Group B Streptococcus (GBS) and Escherichia coli, but the Proteus mirabilis is considered a pathogen with great morbidity and mortality. Proteus mirabilis is a Gram-negative bacterium, more commonly associated with urinary Tract infections, that corresponds to 4% of meningitis cases and it is associated with cerebral empyemas and complications.

    Final Comments: Neonatal meningitis due to Proteus mirabilis is a potential life-threatening condition. This case report is relevant considering the presentation, the unusual pathogen and the outcomes. Patients with these findings should remain in follow-up considering the potential complications post-acute phase of the infection.


    Publication History

    Article published online:
    12 May 2025

    © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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