Question

A 7-day old infant presented to the emergency room with a rigid neck, lethargy, and a temperature of 39˚C. The physician asked the mother about the delivery and she stated it was long process. Her baby was born premature and her water broke 48 hours prior to delivery and she was in labor for 36 hours. The physician decided to perform a lumbar puncture and draw a set of blood cultures. The physician was only able to obtain 1 mL of cerebral spinal fluid. It was submitted to the lab for a WBC count, protein, glucose, culture, and Gram stain.

Question:

a. How should the specimen be processed due to the low volume? (2 points)

Question:

b. What organisms may the laboratory identify causing the meningitis in this age group? (4 points) (There are four)

Laboratory Results:

            Color/Clarity: Colorless and Hazy

            WBC:              190/mm^3

                                    94% of the cells were polymorphonuclear cells

            Protein:                        175 mg/dL

            Glucose:          18 mg/dL

Question:

c. Based on the laboratory data provided, what may be the type of meningitis indicated in this patient? Explain your response. (3 points)

Blood Culture Results at 24 hours:

            Gram positive cocci

            Catalase negative

            BAP: Small zone of beta hemolysis

CSF Culture Results at 24 hours:

Gram positive cocci

            Catalase negative

            BAP: Small zone of beta hemolysis

Question:

d. What is the most probable organism causing the infection in the infant?

Question:

e. How do you think the infant acquired this organism? And what are the associated risk factors for the infant?  

Answer 1

Q. No. a) Answer :

* The minimum requirements of cerebro spinal fluid is 1 ml and up to 3 ml we can collect.

* If not possible 3 ml because here premature baby with the 1 ml also they can perform investigations.

* By putting correct labeling send fluid to the lab for investigations.

b) answer :

* The age of newborn is 7 days, so the baby is early newborn or early neonate.

* the most common causative organism for meningitis in this age group includes ,

* Group B streptococcus agalactae,

* Escherichia coli, it is gram negative bacteria.

* listeria Monocytogence.

These are Main causative organisms.

Q. No. c) Answer :

Based on laboratory data the type of meningitis in this patient is "Bacterial meningitis"

* because the protein levels are high that is 175 mg per dl.

And wbc count also high, 190 mm 3.

* and temperature also 39 degrees Celsius.

* so it is indicates bacterial meningitis.

Q. No. d) answer :

Neonatal meningitis is caused by bacteria that is Listeria Monocytogenes, this is due to food borne infection during pregnancy period it will transmit to the fetus through placenta and causes the meningitis in newborn.