Late-Onset Sepsis and Meningitis Caused by Elizabethkingia meningoseptica: A Case Report

Shasha Liao, Shaoling Qiu, Na Li, Yunyuan Liu, Xiuneng TangDepartment of Clinical Pharmacy, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, People’s Republic of ChinaCorrespondence: Xiuneng Tang, Email txn@gxqfy.cnAbstract: Elizabethkingia meningoseptica is a gram-negative bacillus. Increasing body of literature shows that opportunistic infections may be caused by this Gram negative bacillus in immunocompromised adults and neonates. We describe a case of a preterm neonate born at 33 weeks of gestation who presented with fever and reluctance to feed for two days at one month after birth. Initial laboratory tests of blood and cerebrospinal fluid cultures showed evidence of late-onset sepsis and meningitis caused by E. meningoseptica, which was sensitive to piperacillin/tazobactam, cefoperazone/sulbactam, trimethoprim/sulfamethoxazole, levofloxacin, and minocycline. The neonate underwent sequential anti-infective therapy regimens consisting of: 1) cefoperazone/sulbactam (2:1) in combination with levofloxacin; 2) cefoperazone/sulbactam (2:1) paired with rifampicin; and 3) linezolid administered concomitantly with rifampicin. The neonate exhibited clinical manifestations of ventricular dilatation accompanied by hydrocephalus. The neonate received an 85-day course of anti-infective treatment during hospitalization. Follow-up cranial computed tomography (CT) imaging performed four months post-discharge demonstrated complete resolution of the previously observed complications.Keywords: Elizabethkingia meningoseptica, late-onset sepsis, meningitis, preterm neonate, therapy