Abstract

Neonatal meningococcal meningitis and meningococcal septicaemia is a rare condition. Surveillance in the USA has described an annual incidence of 9 per 100,000. The rate on invasive meningococcal disease in neonates in the UK has not been defined. Following an extensive literature review there is no reported case in an Irish Neonatal Intensive Care Unit.

The patient was a twin, born at 35 weeks gestation by emergency LSCS under general anaesthetic. On day 12 of life she developed temperature instability, poor feeding, vomiting and fleeting bradycardias. A full septic work up revealed a blood culture positive for Neisseria meningitidis serogroup B. Blood PCR was positive for meningococci. Cerebrospinal fluid (CSF) microscopy revealed a white cell count of 7,700, with 30,000 red blood cells, glucose 0.5 mmol/l and protein 3100 mg/l. The CSF was positive for Gram negative meningococci. Cranial ultrasound scan was normal.

The patient received a 21 day course of IV Cefotaxime and Gentamicin. Recovery has been uneventful to date.

Extensive screening for carrier state was performed of 29 medical personnel and 2 close relatives to the infant. All were negative. No secondary cases of meningococaemia occurred among the other infants in the NICU

This case report presents an uncommon aetiology of neonatal meningitis. This represents the first case of meningococcaemia in Ireland occurring in neonatal unit.