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Neonatal Bacillus cereus: an unusual case of congenital pneumonia requiring ECMO
  1. Darren Anderson1,
  2. Sanjay Patel2 and
  3. Antonia Hargadon-Lowe1
  1. 1Paediatric Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Paediatric Infectious Diseases, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Darren Anderson; darren.anderson10{at}nhs.net

Abstract

A term neonate presented with cyanosis from birth, with refractory hypoxaemia despite intubation, administration of 100% oxygen and inhaled nitric oxide. Structural congenital heart disease was excluded. He developed profuse pulmonary haemorrhage at 6 hours of life with worsening hypoxia and was transferred to a paediatric intensive care unit (PICU) for initiation of veno-venous extracorporeal membrane oxygenation (vvECMO). Endotracheal aspirates from both the birth hospital and the PICU were positive for Bacillus cereus, with all other investigations finding no alternative cause for his presentation. Of note, mother was a practising veterinarian raising another potential source of exposure to this pathogen. A full recovery occurred after a total of 5 days of vvECMO, 13 days of ventilation and 20 days of PICU stay.

  • pneumonia (infectious disease)
  • paediatric intensive care
  • neonatal and paediatric intensive care
  • cardiovascular system
  • mechanical ventilation

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Footnotes

  • Contributors DA identified the case to be of interest for publication, reviewed the case and wrote the report, including making the figures. Explained and obtained consent from parents, and approached parents for the 'Patient’s perspective’ section. AH-L supervised DA with writing the report, reviewing and editing the write up and providing insight and explanation of the physiological rationale behind the investigations and management. There are no other contributors to acknowledge.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.