Download PDF
CC BY 4.0 · Journal of Child Science 2024; 14(01): e43-e46
DOI: 10.1055/s-0044-1788046
Case Report

Ureaplasma urealyticum as a Cause of Ventriculitis in an Extremely Low Birth Weight Infant

Garrit K. Meers 
1   Department of Neonatology, Pediatric Intensive Care and Cardiology, University of Oldenburg, Oldenburg, Germany
,
Axel Heep 
1   Department of Neonatology, Pediatric Intensive Care and Cardiology, University of Oldenburg, Oldenburg, Germany
,
Julia Huber
1   Department of Neonatology, Pediatric Intensive Care and Cardiology, University of Oldenburg, Oldenburg, Germany
,
Sandra Gräber 
2   Department of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany
,
Matthias Lange 
1   Department of Neonatology, Pediatric Intensive Care and Cardiology, University of Oldenburg, Oldenburg, Germany
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Ureaplasma urealyticum (Uu) has rarely been described as a cause of ventriculitis in preterm infants. We report a preterm infant in whom Uu was detected in the tracheal secretion. Concurrent intraventricular hemorrhage III° with posthemorrhagic hydrocephalus occurred, necessitating the bilateral insertion of ventriculostomy access devices for treatment. Persisting high cerebrospinal fluid (CSF) protein and pleocytosis in the otherwise clinically unremarkable neonate subsequently led to the targeted detection of Uu in the CSF. Normalization of CSF parameters occurred only after prolonged intravenous and oral macrolide therapy.

Keywords

Ureaplasma urealyticum - neonate - ventriculitis - CNS infection - macrolides


Publication History

Received: 09 January 2024

Accepted: 10 June 2024

Article published online:
03 July 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Murtha AP, Edwards JM. The role of mycoplasma and Ureaplasma in adverse pregnancy outcomes. Obstet Gynecol Clin North Am 2014; 41 (04) 615-627
    CrossrefPubMedSearch in Google Scholar
  • 2 Stol K, Jans J, Ott de Bruin L, Unger W, van Rossum A. Perinatal infections with Ureaplasma. Pediatr Infect Dis J 2021; 40 (5S): S26-S30
    CrossrefPubMedSearch in Google Scholar
  • 3 Sprong KE, Mabenge M, Wright CA, Govender S. Ureaplasma species and preterm birth: current perspectives. Crit Rev Microbiol 2020; 46 (02) 169-181
    CrossrefPubMedSearch in Google Scholar
  • 4 Glaser K, Wohlleben M, Speer CP. An 8-month history of meningitis in an extremely low birth weight infant? Long-lasting infection with Ureaplasma parvum. Z Geburtshilfe Neonatol 2015; 219 (01) 52-56
    PubMedSearch in Google Scholar
  • 5 Xing N, Zhao Z, Li Q, Dong Y, Li J, Zhang S. Ureaplasma parvum meningitis following atypical choroid plexus papilloma resection in an adult patient: a case report and literature review. BMC Infect Dis 2021; 21 (01) 1276
    CrossrefPubMedSearch in Google Scholar
  • 6 Zhan C, Chen L, Hu L. Neonatal Ureaplasma parvum meningitis complicated with subdural hematoma: a case report and literature review. BMC Infect Dis 2021; 21 (01) 268
    CrossrefPubMedSearch in Google Scholar
  • 7 Duan J, Zhang C, Wang J. et al. Diagnosis of Ureaplasma parvum meningitis by mNGS in an extremely low birth weight infant with multi-system lesions. Indian J Med Microbiol 2022; 40 (03) 455-458
    CrossrefPubMedSearch in Google Scholar
  • 8 Silwedel C, Hütten MC, Speer CP. et al. Ureaplasma-driven neonatal neuroinflammation: novel insights from an ovine model. Cell Mol Neurobiol 2023; 43 (02) 785-795
    CrossrefPubMedSearch in Google Scholar
  • 9 Parasuraman JM, Albur M, Fellows G, Heep A. Monitoring intraventricular vancomycin for ventriculostomy access device infection in preterm infants. Childs Nerv Syst 2018; 34 (03) 473-479
    CrossrefPubMedSearch in Google Scholar
  • 10 de Vries LS, Groenendaal F, Liem KD. et al; ELVIS study group. Treatment thresholds for intervention in posthaemorrhagic ventricular dilation: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2019; 104 (01) F70-F75
    CrossrefPubMedSearch in Google Scholar
  • 11 Clifford V, Tebruegge M, Everest N, Curtis N. Ureaplasma: pathogen or passenger in neonatal meningitis?. Pediatr Infect Dis J 2010; 29 (01) 60-64
    CrossrefPubMedSearch in Google Scholar
  • 12 Beeton ML, Spiller OB. Antibiotic resistance among Ureaplasma spp. isolates: cause for concern?. J Antimicrob Chemother 2017; 72 (02) 330-337
    CrossrefPubMedSearch in Google Scholar
  • 13 Almaramhy HH, Al-Zalabani AH. The association of prenatal and postnatal macrolide exposure with subsequent development of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis. Ital J Pediatr 2019; 45 (01) 20
    CrossrefPubMedSearch in Google Scholar
  • 14 Jaruratanasirikul S, Hortiwakul R, Tantisarasart T, Phuenpathom N, Tussanasunthornwong S. Distribution of azithromycin into brain tissue, cerebrospinal fluid, and aqueous humor of the eye. Antimicrob Agents Chemother 1996; 40 (03) 825-826
    CrossrefPubMedSearch in Google Scholar
  • 15 Chang E, Ballard KE, Johnson PN, Nandyal R, Miller JL. Azithromycin for eradication of Ureaplasma and prevention of bronchopulmonary dysplasia in preterm neonates in the neonatal intensive care unit. J Pediatr Pharmacol Ther 2023; 28 (01) 10-19
    PubMedSearch in Google Scholar
  • 16 Del Pozo A, Villa M, Vargas C. et al. Intraventricular hemorrhage induces inflammatory brain damage with blood-brain barrier dysfunction in immature rats. Pediatr Res 2023; 93 (01) 78-88
    CrossrefPubMedSearch in Google Scholar
  • 17 Rodvold KA. Clinical pharmacokinetics of clarithromycin. Clin Pharmacokinet 1999; 37 (05) 385-398
    CrossrefPubMedSearch in Google Scholar