Case 1: The patient was a 3 1/2 week-old male who was born a…
Case 1: The patient was a 3 1/2 week-old male who was born at term. He required intubation at that time and continued to require respiratory support. Over a 24-hour period, the infant developed bulging anterior fontanelles (the “soft spots” in the skull), increased respiratory and heart rates, wide fluctuations in blood pressure, difficulties maintaining adequate tissue oxygenation, and his peripheral white blood cell count increased from 6,300 to 13,700/ml (high abnormal). The child began to have focal seizures as well. A cerebrospinal fluid (CSF) examination showed 3,900 WBC/ml (increased) with 92% neutrophils, glucose 2 mg/dl (decreased), and protein of 350 mg/dl (increased). Gram staining of the child’s CSF showed many gram-positive cocci. Case Study 1 Question 2: What is the most likely organism causing his infection?