Cerebral abscess caused by Serratia marcescens in a premature neonate.
BACKGROUND
Cerebral abscesses are extremely rare in neonates. Serratia marcescens is an unusual cause of sepsis and neurological spread is especially ominous.


OBJECTIVE
To report the case of a 34-week neonate who developed this rare condition and to discuss diagnostic and therapeutic measures.


METHODS
A 34-week male neonate sequentially developed respiratory distress syndrome, early sepsis and necrotizing enterocolitis; later cultures revealed S. marcescens. After deterioration, a cerebral abscess became evident, which revealed S. marcescens. Clinical improvement ensued after high-dose amikacin and meropenem.


CONCLUSIONS
Clinical signs are often non-specific. Proper diagnostic measures, neurosurgical consultation and aggressive antibiotic therapy are essential for these high-risk neonates.
Hirooka
Tatiana Mattos
TM
Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Fontes
Ricardo Braganca de Vasconcellos
RB
Diniz
Edna Maria
EM
Pinto
Fernando Campos
FC
Matushita
Hamilton
H
D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004200:Diseases in Twins / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D000077731:Meropenem; D016868:Serratia Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012706:Serratia marcescens; D013845:Thienamycins / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000583:Amikacin; D000077731:Meropenem