Multiple pneumatoceles and lung abscesses caused by early-onset E. coli sepsis in a preterm neonate. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Tachikawa, Jun; Aizawa, Yuta; Shimotsuma, Taiki; Kaneko, Takayuki; Saitoh, Akihiko
• Is Part Of: Journal of infection and chemotherapy. Volume 29:Issue 4(2023)
• Page Start: 414
• Page End: 417
• Publication Date: 2023-04
• Subjects: Early-onset sepsis -- Escherichia coli -- Lung abscess -- Pneumatocele -- Neonate; EOS early-onset sepsis -- MALDI-TOF MS matrix-assisted laser desorption/ionization time-of-flight mass spectrometry -- CT computed tomography -- NICCD neonatal intrahepatic cholestasis caused by citrin deficiency -- BPD bronchopulmonary dysplasia; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2022.12.015
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Early-onset sepsis (EOS) is a serious and fatal illness in neonates, Group B Streptococcus and Escherichia coli are major causative pathogens. We report a case of EOS and pneumonia caused by E. coli in a preterm neonate with multiple pneumatoceles and lung abscesses. A male neonate weighing 1670g was delivered at 33 6/7 weeks' gestation by a mother with clinical chorioamnionitis. He showed respiratory distress soon after birth and developed septic shock. He was intubated and mechanical ventilation was started. E.coli was detected in blood culture obtained from both the patient and his mother. He developed multiple pneumatoceles and lung abscesses. Surgical drainage was complicated, cefotaxime was thus continued until day 74. Pneumatoceles and lung abscesses are complications of neonatal pneumonia, rarely reported by E. coli . Multiple lung abscesses in our patient are distinct from single abscesses in previous case studies of neonatal lung abscesses. We speculate that bacteremia along with pneumatoceles led to multiple lung abscesses in our patient. These complications require long-term antibiotic therapy, to minimize morbidity and mortality, and should thus be considered when managing EOS caused by E. coli .