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J Pediatr Infect Dis
DOI: 10.1055/s-0044-1793910
Case Report

Enterobacter cloacae as a Rare Cause of Cerebral Abscesses in a Neonatal Late-Onset Sepsis—a Case Report and Literature Review with Focus on Risk Factors, Diagnostics, and Treatment

Yildiz Yildirim 
1   Department of Pediatrics, Helios Klinikum, Academic Hospital of RWTH Aachen University, Krefeld, Germany
,
Ruy Perez
1   Department of Pediatrics, Helios Klinikum, Academic Hospital of RWTH Aachen University, Krefeld, Germany
,
Rüdiger Wentzell
2   Department of Pediatrics, Rheinlandklinikum, Neuss, Germany
,
Clemens Andrée
1   Department of Pediatrics, Helios Klinikum, Academic Hospital of RWTH Aachen University, Krefeld, Germany
,
Martin Weinzierl
3   Department of Neurosurgery and Spinal Surgery, Helios Klinikum, Academic Hospital of RWTH Aachen University, Krefeld, Germany
,
Norbert Utz
4   Department of Diagnostic and Interventional Radiology, Helios Klinikum, Academic Hospital of RWTH Aachen University, Krefeld, Germany
,
Tim Niehues
1   Department of Pediatrics, Helios Klinikum, Academic Hospital of RWTH Aachen University, Krefeld, Germany
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Abstract

Late-onset sepsis (LOS; sepsis occurring after the first 72 h of life) increases the morbidity and mortality of premature neonates, especially those with very low birth weight (≤1,500 g). In LOS, Enterobacter cloacae has been rarely described as a cause of secondary brain abscesses. Our case report summarizes important aspects of cerebral abscesses due to an E. cloacae sepsis in a preterm neonate. Our patient received surgical abscess drainage and rational antibiotic treatment, employing prolonged meropenem infusions plus fosfomycin and subsequent treatment with oral trimethoprim/sulfamethoxazole. Furthermore, we present a review of the current literature from 2009 to 2022, comparing cases similar to our case.

Keywords

cerebral abscesses - Enterobacter cloacae - neonatal sepsis - late-onset sepsis - antimicrobial resistance


Publication History

Received: 13 January 2024

Accepted: 11 October 2024

Article published online:
19 November 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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