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Case Report
Paenibacillus thiaminolyticus sepsis and meningoencephalitis in a 37-day old preterm infant
1 Clinical Pediatric Infectious Diseases Fellow, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
2 Associate Professor, Department of Pediatrics, University of Minnesota and Hennepin Healthcare, Minneapolis, Minnesota, USA
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Kristen Bastug
2450 Riverside Avenue, Academic Office Building, AO-103, Minneapolis, MN 55454,
USA
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Article ID: 100019Z19KB2023
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Bastug K, Siddappa AM, Maroushek S. Paenibacillus thiaminolyticus sepsis and meningoencephalitis in a 37-day old preterm infant. J Case Rep Images Pediatr 2023;5(1):16–20.ABSTRACT
Introduction: The Paenibacillus genus consists of saprophytic organisms that are commonly associated with soil, water, plants, feces, and diseased insect larvae. Human infection is rare. This disease typically occurs in immunocompromised hosts, adults with a history of intravenous drug use, and hosts with prosthetic medical devices. There are a limited number of case reports describing Paenibacillus infections in neonates. This is the second published instance of pediatric meningoencephalitis caused by Paenibacillus thiaminolyticus in a preterm infant with intrauterine drug exposure.
Case Report: A 37-day-old male infant with a history of prematurity of 33 weeks completed gestation presented to the Emergency Department for acute onset poor feeding, poor color, and unresponsiveness at home. Examination revealed cyanosis, apnea, and hypotonia. Vital signs were significant for hypotension and hypothermia. Initial labs revealed a metabolic acidosis, elevated C-reactive protein, normal complete white blood cell count, and a negative viral respiratory pathogen panel. Aerobic blood culture and cerebrospinal fluid (CSF) culture were positive for P. thiaminolyticus within 24 hours. Cranial ultrasound and magnetic resonance imaging revealed changes concerning for liquefactive meningoencephalitis. The infant was admitted to the neonatal intensive care unit (NICU) and ultimately discharged home on a “do not resuscitate/do not intubate” status and later died at 11 months of age.
Conclusion: Paenibacillus species are common environmental organisms but can cause devastating disease in neonates. This is the second reported case of a preterm infant with P. thiaminolyticus infection and inutero drug exposure (IUDE), supporting that prematurity and IUDE may be risk factors for severe disease.
Keywords: Bacillus, Meningitis, Paenibacillus thiaminolyticus, Prematurity
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Acknowledgments
The authors would like to thank Dr. Christopher Palmer, MD, from the Department of Radiology at Hennepin Healthcare for assistance with preparing the radiographic images for publication.
Author ContributionsKristen Bastug - Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ashajyothi M Siddappa - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Stacene Maroushek - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was not obtained from the patient for publication of this article due to the deidentified information presented and patient death.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Kristen Bastug et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
