A rare case of neonatal meningoencephalitis from Paenibacillus thiaminolyticus

Abstract

Paenibacillus infections can be life threatening and are being reported with increasing incidence. There are only a few case reports of infections and are mainly described in patients who are immunocompromised, injection drug users, or those with prosthetic devices. Due to improved testing and identification, it appears that these infections may not be as rare as once perceived. We present a case of a 16-day-old term neonate who presented with status epilepticus and was found to have Paenibacillus thiaminolyticus meningoencephalitis. The patient was successfully treated with a combination of ampicillin and ceftazidime then meropenem. To our knowledge, this is the first reported case of an infant in the United States who survived this serious invasive infection. We also present an option for therapy given the difficulty treating invasive intracranial infections.

Keywords: Paenibacillus thiaminolyticus; encephalitis; meningitis; meropenem; neonate.

Fig. 1.

a and b, Diffusion sequence (a) and T2 (b) weighted sequences with arrows pointing to pus within in the abscesses. (c), T1 post-contrast sequence with arrowheads pointing to enhancement of the abscess walls. (d) and (e), Diffusion sequence (d) and T2 (e) sequences with arrows pointing to pus within the ventricles. (f), T1 post-contrast sequence with arrowheads pointing to enhancement of the ependymal surfaces of the ventricles.

Fig. 2.

Trend of white blood cell count in the CSF (K µl⁻¹) with important events. 1) Meropenem started; 2) Transition to continuous meropenem; 3) Identification of P. thiaminolyticus ; 4) Sensitivities obtained.