Unusual presentation of late-onset disseminated staphylococcal sepsis in a preterm infant

Abstract

An ex-30-week gestation, preterm male baby was admitted to a tertiary neonatal unit and noted to have increased ventilator requirements and diagnosed with sepsis. The baby also developed an abscess over the left elbow and over the xiphisternum along with a decrease in movement of the left hand and the right leg. Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus (SA) was isolated from the blood culture. A whole body MRI showed disseminated abscess with multiple foci in the lung, left elbow and over the xiphisternum. Disseminated sepsis with multiple septic foci has not been previously reported in neonates. We would like to highlight the fact that sepsis due to PVL toxin-producing SA can cause significant morbidity and mortality in neonates. Proper screening should be done to rule out septic foci in neonates. MRI is a good non-invasive investigation to document septic foci in a neonate and rule out multiorgan involvement.

Keywords: neonatal intensive care; nosocomial infections; pneumonia (infectious disease); radiology.

Figure 1

Baby had cavitating lesions in the right upper lobe, right lung base and also in the left lung, which was not picked up previously on the chest X-ray. There was also a lower presternal collection measuring 13×4 mm.

Figure 2

MRI showed multiloculated collection in the left antecubital fossa measuring 33×17 mm.

Figure 3

Small abscess overlying xiphisternum.