A 36-week-2-day-old male infant was admitted to the neonatal unit with respiratory distress, hypoglycaemia and suspected early onset neonatal sepsis for respiratory support, monitoring and intravenous antibiotics. His initial C-reactive protein was 12 mg/L, this increased to 66 mg/L at 24 hours. Blood cultures at 48 hours confirmed Neisseria meningitidis serogroup B. As the isolate was sensitive to benzylpenicillin the same antibiotic was continued for a total of 7 days. His mother remained asymptomatic but was monitored closely. Ciprofloxacin chemoprophylaxis was given to close family contacts. Neisseria meningitidis causing early onset neonatal sepsis is extremely rare and neonates may have minimal symptoms at presentation. A table reviewing all documented cases of early onset neonatal sepsis caused by Neisseria meningitidis over a 102-year time period is included. There is need for early identification and initiation of empirical antibiotic therapy pending confirmation and sensitivities.
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1.NICE (2012). Antibiotics for early-onset neonatal infection: antibiotics for the prevention and treatment of early-onset neonatal infection. Available at: https://www.nice.org.uk/guidance/cg149/evidence/cg149-antibiotics-for-earlyonset-neonatal-infection-full-guideline2 (Accessed on 11st December, 2018)
2.Vergnano S, Menson E, Kennea N, et al. Neonatal infections in England: the NeonIN surveillance network. Arch Dis Child Fetal Neonatal Ed 2011; 96: F9-F14.
3.Edge C, Waight P, Ribeiro S, Borrow R, Ramsay M, Ladhani S. Clinical diagnoses and outcomes of 4619 hospitalised cases of laboratory-confirmed invasive meningococcal disease in England: linkage analysis of multiple national databases. J Infect 2016; 73: 427-436.
4.Kiray Baş E, Bülbül A, Cömert S, Uslu S, Arslan S, Nuhoglu A. Neonatal infection with Neisseria meningitidis: analysis of a 97-year period plus case study. J Clin Microbiol 2014; 52: 3478-3482.
5.Zhang J, Wang Y, Luo J, Ding Y, Shao F. Meningitis caused by Neisseria meningitides serogroup B in a newborn in China. SOJ Microbiol Infect Dis 2016; 4: 1-3.
6.Shepard CW, Rosenstein NE, Fischer M; Active Bacterial Core Surveillance Team. Neonatal meningococcal disease in the United States, 1990 to 1999. Pediatr Infect Dis J 2003; 22: 418-422.
7.Bosman M, Archary M, Mahabeer P, Bobat R. Early onset meningococcal meningitis. South Afr J Epidemiol Infect 2013; 28: 177-179.
8.Chacon-Cruz E, Alvelais-Palacios JA, Rodriguez-Valencia JA, Lopatynsky-Reyes EZ, Volker-Soberanes ML, Rivas-Landeros RM. Meningococcal neonatal purulent conjunctivitis/sepsis and asymptomatic carriage of N. meningitidis in mother's vagina and both parents' nasopharynx. Case Rep Infect Dis 2017; 2017: 6132857.
9.Bilal A, Taha MK, Caeymaex L, Cohen R, Levy C, Durrmeyer X; Groupe des Pédiatres et microbiologistes de l’Observatoire National des Méningites; Members of the National Reference Center for Meningococci. Neonatal meningococcal meningitis in France from 2001 to 2013. Pediatr Infect Dis J 2016; 35: 1270-1272.
10.Heath PT, Nik Yusoff NK, Baker CJ. Neonatal meningitis. Arch Dis Child Fetal Neonatal Ed 2003; 88: F173-F178.
11.Smith SM, Roy Babbitt MF, Schwartz A, Gomez MR, Fox MD. Early onset neonatal Neisseria meningitidis meningitis: a case report. EC Paediatr 2015; 1: 35-38.