title: [Complicating neonatal Escherichia coli meningitis].
abstract: Neonatal Escherichia coli meningitis is a serious disease with high mortality and poor outcome. Ventriculitis, brain abscess and subdural empyema are frequent, with no homogeneous recommendations available for these complications. The case of a newborn infant who developed sepsis and meningitis caused by E.  coli is presented. During intravenous treatment with ampicillin, cefotaxime and gentamycin in recommended doses, the patient developed severe subdural abscesses detected on MRI. After consequent antibiotic therapy over 2 months with fosfomycin, amikacin and meropenem the patient improved clinically and the abscesses regressed and disappeared without neurosurgical intervention. At the age of 6.5 months the infant is healthy and well developed. The conservative treatment of subdural abscesses complicating neonatal Escherichia coli meningitis without neurosurgical intervention is possible. The treatment of the individual case should be discussed between pediatrician and neurosurgeon.
authors.affiliation: Kinderklinik, Städtisches Klinikum Lüneburg. Josef.Sonntag@klinikum-lueneburg.de
authors.forename: J
authors.initials: J
authors.lastname: Sonntag
authors.forename: D
authors.initials: D
authors.lastname: Kaczmarek
authors.forename: G
authors.initials: G
authors.lastname: Brinkmann
authors.forename: G
authors.initials: G
authors.lastname: Kammler
authors.forename: H H
authors.initials: HH
authors.lastname: Hellwege
mesh_terms: D000583:Amikacin / Q000008:administration & dosage; D001921:Brain / Q000473:pathology; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004453:Echoencephalography; D013354:Empyema, Subdural / Q000175:diagnosis / Q000188:drug therapy*; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005578:Fosfomycin / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008279:Magnetic Resonance Imaging; D020814:Meningitis, Escherichia coli / Q000175:diagnosis / Q000188:drug therapy*; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D010348:Patient Care Team; D013845:Thienamycins / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D013845:Thienamycins; D005578:Fosfomycin; D000583:Amikacin; D000077731:Meropenem