No abstract

A normal full-term baby boy, born by vaginal delivery, became ill on day 2 with fever and failure to feed. CSF examination revealed 260 x 10(6)/l leucocytes, mainly mononuclears, protein 2 g/l and glucose zero. Pasteurella multocida was isolated in pure culture from the baby's CSF, blood and umbilicus and from the mother's vagina. The baby was treated with i.v. penicillin for 7 weeks. Progress was complicated by mild hydrocephalus, which resolved, and prolonged low grade fever. Recovery was complete, without neurological sequelae. This case illustrates that P. multocida can infect the vagina where it presents a hazard to a newborn infant delivered vaginally. Early diagnosis is critical, intravenous high dose penicillin being the treatment of choice.

ObjectiveTo report the first case of Haemophilus paraphrophilus vertebral osteomyelitis — the second reported case of osteomyelitis of any site caused by this organism. Clinical featuresA 41‐year‐old male bus driver with no significant previous medical history presented with severe abdominal and back pain, which was eventually localised to the eleventh thoracic vertebra (T11). H. paraphrophilus was isolated from pus aspirated from the vertebral body. Interventions and outcomeThe patient was treated with penicillin given intravenously for four weeks, then with antibiotics given orally for a further three weeks, with good clinical response. ConclusionH. paraphrophilus is an infrequent pathogen which may be difficult to identify and test for antibiotic susceptibility, but can cause serious infection, including primary haemato‐genous osteomyelitis.