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Article in Japanese

A case of infected cephalohematoma associated with ESBL-producing Escherichia coli

Takanori NOTO1), Ayumi FUKUDA1), Kimitaka NAKAZAKI1), Emiko MOMOKI1), Tatsuo FUCHIGAMI1), Yukihiko FUJITA2), Yasuji INAMO1), Shori TAKAHASHI1)

Bacterial infection of the cephalohematoma is rare. A male newborn had an infected cephalohematoma caused by extended-spectrum β-lactamase (ESBL) that produced Escherichia coli. This was the first case in Japan. He had an infected cephalohematoma and epidural hematoma resulting from a vacuum delivery. At 30 days old, he was admitted to this hospital with fever and poor suckling. His peripheral blood showed a white blood cell count of 14,100/μl, and his C-reactive protein level was 8.69 mg/dl. These indications with pyuria led to the diagnosis of urinary tract infection. Initially, he was treated with cefotaxime. However, his fever continued and his cephalohematoma grew larger. The antibiotic was changed to meropenem and surgical incision and drainage were perfomed five days after admission to treat the hematoma. ESBL producing Escherichia coli in the blood, urine, and aspirate fluid from the hematoma was detected. His condition subsequently improved. When the cephalohematoma becomes enlarged, reddish, and warm, bacterial infection of the cephalohematoma must be considered, and a diagnostic tap should be performed immediately. Recently, pediatric reports have stated that ESBL-producing organisms causing urinary tract infections are on the rise. Physicians should be aware of the prevalence of these resistant organisms and take appropriate measures promptly.

1) Department of Pediatrics and Child Health, Nihon University School of Medicine

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Received December 9, 2015
Accepted May 23, 2016

28 (2):105─109,2016