Successful Treatment of Elizabethkingia Meningosepticum Meningitis
E. meningoseptica, a high-alert organism associated with meningitis among premature underweight neonates. A high degree of resistance to most broad-spectrum antibiotics makes its management a challenging task. Here is the review of the successful treatment of Elizabethkingia meningoseptica Meningitis at Prashanth Hospitals:
- Term (38 weeks) - A male neonate born to a 23-year old patient, through natural conception with no antenatal illness, by LSCS, with a birth weight of 3.2kg, cried well at birth, shifted to mother side, started on direct breastfeeds and was discharged on day 4 of life.
- The little one was admitted on day 5 of life with fever and lethargy. The sepsis screen came back positive and the baby was started on IV Piperacillin – Tazobactum and Amikacin.
- In view of persisting fever, CSF analysis done on day 7 of life isolated Elizabethkingia meningosepticum (EKM) a gram-negative bacteria.
- IV Levofloxacin was added according to the sensitivity pattern. IV Cefoperazone – Sulbactum was also added after 3 days as the repeat CSF analysis showed persisting inflammatory changes but was sterile.
- The baby became afebrile, IV antibiotics were given for 3 weeks, and discharged without any morbidity.
- Meningitis due to EKM is associated with high mortality of up to 57% and severe post-meningitic sequelae like hydrocephalus, deafness, and developmental delay.
- EKM is ubiquitous and the common source is water.
- A high index of suspicion is needed.
- The timely diagnosis and intervention with appropriate antibiotics reduces the risk of mortality and neurologic sequelae as in this baby.
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