Research Article | DOI: https://doi.org/10.31579/2690-4861/925
¹Department of Pediatrics, University Hospital Center Zagreb, Croatia.
²Department of Pediatrics, University Hospital Mostar, Bosnia and Herzegovina.
³Department of Neurosurgery, University Hospital Center Zagreb, Croatia.
⁴University of Mostar School of Medicine, Medical Student.
*Corresponding Author: Milivoj Novak, Department of Pediatrics University Hospital Center Zagreb, Croatia.
Citation: Milivoj Novak, Teo Tomić, Zdravko Kuzman, Bruno Novak, Pavle Miklić, (2025), Neonatal Meningitis: A Disastrous Outcome of Klebsiella pneumoniae Infection, International Journal of Clinical Case Reports and Reviews, 30(1); DOI:10.31579/2690-4861/925
Copyright: © 2025, Milivoj Novak. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 29 August 2025 | Accepted: 11 September 2025 | Published: 19 September 2025
Keywords: neonatal meningitis; klebsiella pneumoniae; brain abscess; hydrocephalus; external ventricular drain; infant neurosurgery; cranial destruction; skin graft
A 4-month-old male infant was transferred to our hospital for evaluation of a progressive cranial defect with purulent drainage. According to extremely limited available medical records, the child had been diagnosed with neonatal bacterial meningitis on day 2 of life. Klebsiella pneumoniae was isolated from cerebrospinal fluid (CSF), and intravenous antibiotics were initiated.
A 4-month-old male infant was transferred to our hospital for evaluation of a progressive cranial defect with purulent drainage. According to extremely limited available medical records, the child had been diagnosed with neonatal bacterial meningitis on day 2 of life. Klebsiella pneumoniae was isolated from cerebrospinal fluid (CSF), and intravenous antibiotics were initiated. Hydrocephalus developed by the third week of life, necessitating placement of an external ventricular drain (EVD). Despite prolonged antibiotic treatment and serial CSF sampling, the infection persisted.
On admission, the infant exhibited a large cranial defect with destruction of the scalp, bone, dura, and cerebral parenchyma. The right parietal bone was exposed and protruded through necrotic soft tissue, with ongoing purulent discharge. Neurological examination was grossly unremarkable. Emergency debridement and skin grafting were performed. The child was discharged in stable condition to local care but was lost to follow-up.
Figure 1: Superior cranial view demonstrating purulent destruction of the scalp, dura, and calvarium with exposed parietal bone.
Figure 2: Right lateral view showing a collapsed cranial vault and infected soft tissues.
Figure 3: Intraoperative view demonstrating exposed brain tissue and purulent material
Figure 4: Right profile view after skin grafting, showing a flattened cranial vault and defect coverage.
This case highlights a rare and visually striking consequence of neonatal Klebsiella pneumoniae meningitis, illustrating the potential for cranial and cerebral destruction despite likely appropriate early intervention. EVD placement, though necessary, may serve as a conduit for persistent Gram-negative CNS infection in neonates.
Early detection of treatment failure, rigorous infection control, and prompt neurosurgical assessment are essential in such high-risk neonatal infections. Basu et al. (2001) provided one of the earliest documented cases of neonatal Klebsiella brain abscess. A 2025 case series further emphasized the importance of early surgical evacuation and prolonged antimicrobial therapy, showing improved outcomes.
Neonatal Klebsiella pneumoniae meningitis can result in catastrophic neurologic sequelae even with timely treatment. This case underscores the importance of aggressive monitoring and multidisciplinary management when complications arise.
None declared.
Dear Editorial Team, Clinical Medical Reviews and Reports. My experience with the journal was highly positive. The peer-review process was rigorous, constructive, and completed in a timely manner. The reviewers provided valuable comments that helped improve the quality and clarity of our manuscript. The editorial office was professional, responsive, and supportive throughout all stages of the publication process. Communication was clear and efficient, and any questions were addressed promptly. Overall, I found the journal to maintain high scientific standards and an excellent publication workflow. I would be pleased to consider submitting future work to this journal. Best wishes from, Elena Popa.
It was my pleasure to submit my testimonial concerning the Reviewer Board of our Scientific Journal “Brain and Neurological Disorders”. The Reviewers focused on some modifications and their contribution was helpful. The ladies of our Editorial Office were also supported my efforts. It was my honor to have such a co-operation and I am looking forward for more collaboration.
Dear Grace Pierce, Editorial Coordinator of Journal of Clinical Research and Reports, Thank you for the speedy and efficient peer review process. I appreciate the fact that your peer reviewers do not take months to respond like with some other journals. I would also like to thank the editorial office for responding quickly to my questions. It is an excellent journal. I plan to submit more manuscripts in the future. Best wishes from, Robert W. McGee
Dear Grace Pierce, Editorial Coordinator of Journal of Clinical Research and Reports, Working with you and your team on our recent publication in JCRR has been a truly wonderful and enjoyable experience. The responses were prompt, and the reviewers were patient, constructive, and highly professional. One reviewer in particular gave me the feeling that a professor was carefully reading and commenting on my coursework, which was deeply touching. The entire process was straightforward and hassle‑free, with no tedious online forms to complete. I highly recommend this journal. Best wishes from, DR Aibing Rao, Head of R&D
I Appreciate the Opportunity to Share my Experience with the Journal of Clinical Research and Reports. The peer review process was timely and constructive, and the feedback provided helped improve the quality of our manuscript. The editorial office was professional, responsive, and supportive throughout the process, ensuring smooth communication and efficient handling of the submission. Overall, it was a positive experience collaborating with your team.
Dear Mercy Grace, Editorial Coordinator of Obstetrics Gynecology and Reproductive Sciences, We would like to express our gratitude for your help at all stages of publishing and editing the article. The editors of the magazine answer all the necessary questions and help at every stage. We will definitely continue to cooperate and publish other works in the Obstetrics Gynecology and Reproductive Sciences! Best wishes from, Alla Konstantinovna Politova,
