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The Journal of Pediatric Infectious Diseases and Immunology > Vol.22 No.4 contents > Abstract

Article in Japanese

A neonate with meningitis and brain abscess caused by Campylobacter fetus subsp. fetus: Diagnosis with broad-range PCR

Yukitsugu NAKAMURA1), Yusuke MIYAJI1), Junichiro TSURUOKA1), Tomohiro KATSUTA1,2), Satoshi TATEYAMA1), Tadaomi TOKUTAKE1), Natsuki NAKAJIMA1), Toshiro GOSHIMA1), Kiyofumi OHKUSU3), Tatsuo KATO1,2)

Campylobacter fetus subsp. fetus (C. fetus) is a rare human pathogen that causes systemic infections such as bacteremia, meningitis, and vascular infection, mainly in patients with suppressed immune systems and in neonates. We report a case of a neonate with meningitis and brain abscess caused by C. fetus; broad-range PCR was used for the diagnosis. A 12-dayold boy who presented with fever and poor feeding was admitted to a hospital. He was diagnosed with meningitis on the basis of laboratory test results. Examination of the cerebrospinal fluid (CSF), which was obtained on admission, revealed pleocytosis, hypoglycorrhachia, and increased protein levels. Although treatment for bacterial meningitis was started immediately with ampicillin, cefotaxime, meropenem, intravenous immunoglobulin, and dexamethasone, he was complicated by brain abscess and hydrocephalus. Furthermore, the pathogenic bacteria that caused meningitis and brain abscess were not detected in the CSF or blood cultures, which were obtained before administration of the antibiotics. To detect the pathogenic bacteria, we performed a broad-range PCR by using CSF and brain abscess. The PCR analysis revealed the presence of C. fetus in both CSF and brain abscess. It has been reported that in Japan, most mothers of neonates infected with C. fetus consumed raw meat or liver during pregnancy; this neonate's mother had also consumed raw liver during late pregnancy. To prevent neonatal infection caused by C. fetus, it is necessary to educate women about diet during pregnancy. Broad-range PCR is a useful diagnostic tool for culture-negative meningitis.

1) Department of Pediatrics, St. Marianna University School of Medicine
2) National Center for Child Health and Development
3) Department of Microbiology, Regeneration and Advanced Medical Science, Gifu University Graduate School of Medicine

Key words
Received April 22, 2010
Accepted August 23, 2010

22 (4):357─361,2010