Case 6 History ---- This 6 day old male was the 1620g product of a 31 week gestation complicated by premature separation of the placenta. The patient had respiratory distress at birth (Apgar 7 at one minute, and 6 at 5 minutes} and was transferred to SLCH where therapy for hyaline membrane disease was instituted. On the third day he developed seizure activity. Lumbar puncture revealed blood-tinged fluid and Gram-positive cocci. He received antibiotics and medication for control of seizure activity. During the six days of hospitalization he required high levels of O2 and passed away. Group B beta-streptococci were cultured from blood and CSF postmortem.
At autopsy findings revealed an acute fibrinopurulent meningitis at the base of the brain and over the temporal lobes with Gram-positive intracellular cocci and intraventricular hemorrhage. The source of infection was the respiratory tract which showed marked hyaline membrane disease, as well as components of oxygen toxicity, namely focal intra-alveolar hemorrhage and bronchial squamous rnetaplasia.
