Escherichia coli extended spectrum beta-lactamase meningitis in 3 months infant with subdural abscess and communicating hydrocephalus: A case report.

INTRODUCTION AND

IMPORTANCE

Escherichia coli ESBL as the etiology of meningitis is rarely found and frequently missed in infants. Escherichia coli found in the environment is an indication of fecal contamination.

CASE PRESENTATION: A 3-month-old infant presented with focal seizures without fever, accompanied by positive meningeal sign and bulging large fontanelle. Laboratory examination found an increase in inflammation marker. A head CT scan showed hydrocephalus and subdural cysts.

CLINICAL DISCUSSION: The patient underwent a burr hole drainage. Subdural abscesses with yellowish pus and hydrocephalus were found during the operation. Escherichia coli ESBL growth from the pus culture. This patient diagnosed as meningitis, subdural abscess and communicating hydrocephalus. Evacuation of the subdural abscess by burr hole drainage, meropenem treatment, and shunt was placed in this case.

CONCLUSION

We suggest the source of infection in this patient related to poor hygiene practices prior to formula preparation. Early diagnosis and treatment are essential to prevent morbidity and mortality.