Neonatal Meningitis and Subdural Empyema Caused by an Unusual Pathogen.

We report a case of neonatal meningitis with subdural empyema, caused by Ureaplasma parvum. In this case, diagnosis was made by genus-specific polymerase chain reaction, after regularly used diagnostic techniques failed. This unusual pathogen should be considered in cases that do not respond to therapy and/or where cultures for typical pathogens in neonatal sepsis and meningitis remain negative.

Mycoplasma hominis and Ureaplasma urealyticum in neonates with suspected infection.

The role of genital mycoplasmas in the pathogenesis of neonatal infection is incompletely understood. We performed nasopharyngeal, blood and cerebrospinal fluid (CSF) cultures for Mycoplasma hominis and Ureaplasma urealyticum in 69 neonates who underwent a diagnostic workup for suspected sepsis. The mean gestational age was 35.9 weeks (range, 25 to 42 weeks) with a mean birth weight of 2386 g (range, 652 to 4420 g). Twenty-seven infants (39.1%) had positive nasopharyngeal cultures; 6 were positive for M. hominis, 10 for U. urealyticum and 11 for both organisms. Seven (26%) of these 27 patients developed chronic lung disease compared with 2 (4.7%) infants in the non-colonized group. Nine infants had positive CSF cultures for M. hominis and one infant had a positive CSF culture for U. urealyticum. All blood cultures were sterile. One of the infants with a positive CSF culture for M. hominis had clinical evidence of systemic infection. All of the infants were treated with antibiotic agents that were not active against mycoplasmas. These data indicate that genital mycoplasmas can be found commonly in the CSF and nasopharynx of infants with suspected sepsis. Their etiologic role in the causation of infection and chronic lung disease, however, remains unclear.

Ureaplasma urealyticum in the cerebrospinal fluid of a premature infant.

A premature infant, born at 28 weeks' gestation, was found to be colonized with Ureaplasma urealyticum and developed intraventricular hemorrhage and progressive hydrocephalus during the first weeks of life. The organism was isolated from the infant's cerebrospinal fluid in the absence of marked cerebrospinal fluid pleocytosis, but meningitis was suspected on the basis of low glucose and high protein content. Since this organism was resistant to erythromycin by clinical criteria, the infant was treated with chloramphenicol for 20 days. Cerebrospinal fluid sterilization was demonstrated; hydrocephalus, however, was persistent and made intraventricular shunt placement necessary.