Plesiomonas shigelloides Septicemia and Meningitis in a Neonate

Abstract

A newborn infant is described who presented with septicemia and meningoencephalitis caused by Plesiomonas shigelloides, a Gram-negative rod belonging to the family Vibrionaceae. This appears to be the first documented case in a neonate in Canada. Despite prompt treatment with appropriate antibiotics, he developed endophthalmitis and lytic brain lesions.

Meningoencephalitis caused by Plesiomonas shigelloides in a Chinese neonate: case report and literature review

“…The search terms used were: meningitis or meningoencephalitis and Plesiomonas shigelloides or Aeromonas shigelloides . Thirteen papers of neonatal with meningitis/meningoencephalitis caused by Plesiomonas shigelloides / Aeromonas shigelloides are found and two papers described the same case [ 13 , 16 ]. So the relevant features of the 12 reported cases of neonatal with meningitis/meningoencephalitis caused by P. shigelloides are summarized in the Table 1 .…”

“…Severe jaundice and/or fever are common first signs in most cases [ 4 , 5 , 9 - 15 ], and other common accompanied symptoms including irritability [ 11 , 13 - 15 ], anorexia [ 12 - 15 ], seizure [ 5 , 8 , 10 , 13 ], lethargy [ 5 , 15 ], vasculitic type rash [ 13 ], and so on. With the development of disease, circulatory collapse may quickly appear and multiple organs could be affected [ 8 , 10 ].…”

“…With the development of disease, circulatory collapse may quickly appear and multiple organs could be affected [ 8 , 10 ]. Hypotonia [ 4 , 12 ], hypermyotonia [ 11 ] or endophthalmitis [ 13 ] may appear. It is difficult to diagnose the Plesiomonas shigelloides infection at early stages by the nonspecific symptoms and signs.…”

“…Four of five survived neonates were treated with cefotaxime [ 9 , 12 , 13 , 15 ]. Five patients treated with ampicillin plus an aminoglycoside or rifampicin died [ 4 , 5 , 7 , 8 , 14 ].…”

“…One treated with mezlocillin and netilmicin first and cefotaxime was added 3 hr after admission then changed to gentamicin and cefotaxime died due to cessation of respiratory therapy at the age of 51 days [ 11 ]. The destruction of the CNS happened in two babies [ 11 , 13 ]. By these experiences, we consider it is the key point that third-generation cephalosporins or meropenem is given as early as you can.…”