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Neonatal Med > Volume 24(4); 2017 > Article
Neonatal Medicine 2017;24(4):187-191.
DOI: https://doi.org/10.5385/nm.2017.24.4.187    Published online November 30, 2017.
Case Report of Neonatal Proteus mirabilis Meningitis and Brain Abscess with Negative Initial Image Finding: Consideration of Serial Imaging Studies.
Mi Hae Chung, Geonju Kim, Aluem Han, Juyoung Lee
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. frocner@catholic.ac.kr
Abstract
Proteus mirabilis (P. mirabilis) meningitis in a neonate is rare, but its recognition is important because the disease progresses rapidly and has poor prognosis. A 4-day-old premature female infant born at 36 weeks and 5 days of gestation presented with symptoms of fever and icteric skin. Initial cerebrospinal fluid findings suggested bacterial meningitis, and treatment with antibiotics was started. On the third day, P. mirabilis growth was found in both blood and cerebrospinal fluid cultures and brain computed tomography revealed normal findings. The patient showed improved clinical symptoms, but brain magnetic resonance imaging on hospital day 18 revealed a brain abscess measuring 4.5×3.1×3.1 cm in the right frontal lobe. Cyst drainage was performed immediately and a catheter was inserted. Follow-up computed tomography revealed a tiny abscess remaining in the right frontal lobe, and follow-up magnetic resonance imaging later demonstrated marked interval regression in the size of the abscess. The patient was discharged on day 57 of hospitalization in good condition. Serial brain imaging should be considered in neonatal cases of P. mirabilis meningitis.
Key Words: Proteus mirabilis, Meningitis, Brain abscess, Newborn
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