Pseudomonas aeruginosa as an Unexpected Cause of Early Neonatal Meningitis: Two Case Reports

Abstract

Pseudomonas aeruginosa is a rare cause of neonatal meningitis, usually associated with nosocomial infection, prematurity, or immunodeficiency. We report two full-term neonates, one without identifiable risk factors and another in whom a health care–associated infection could not be excluded. The first presented with hematemesis and hypoglycemia, and the second with fever, jaundice, and hypotonia. Cerebrospinal fluid analysis in both cases showed pleocytosis, elevated protein, and low glucose. Cultures grew Pseudomonas aeruginosa. Both infants received targeted therapy including ceftazidime and ciprofloxacin. Head ultrasound revealed ventriculitis, subependymal hemorrhage, and white matter hyperechogenicity in one patient. Extensive investigations including immunological workup and sweat testing were normal. Both infants had favorable short-term outcomes.