Infant Journal
for neonatal and paediatric healthcare professionals

Necrotising enterocolitis in a preterm infant with late-onset group B streptococcus sepsis and meningitis

Here we report the case of a preterm infant born at 29+5 weeks’ gestation who presented at two weeks of age with symptoms of necrotising enterocolitis (NEC) and features of late-onset sepsis. NEC was diagnosed radiologically and group B streptococcus (GBS) was isolated in blood and cerebrospinal fluid cultures. The baby was treated medically for NEC, sepsis and meningitis and later suffered significant complications of meningitis with hydrocephalus. This case report describes the link between late-onset GBS sepsis and NEC.

Dyanne Imo-Ivoke
ST2 Paediatrics
Hull University Teaching Hospitals NHS Trust

Joanna M Preece
Consultant Neonatologist, Department of Neonatology, University Hospitals of Leicester

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group B streptococcus; necrotising enterocolitis; late-onset sepsis; meningitis; preterm neonate
Key points
  1. NEC may be caused by GBS but NEC remains a poorly understood condition and no assumptions should be made regarding its causative factors.
  2. In preterm infants colonised with GBS and at risk of NEC, NEC may be the primary trigger of blood sepsis and associated severe complications such as meningitis.
  3. In a patient with GBS-associated meningitis, it is relevant to institute cranial monitoring.

Also published in Infant:

Human milk oligosaccharides and necrotising enterocolitis
Human milk is known to reduce the risk of necrotising enterocolitis (NEC) in preterm infants, but mechanisms are poorly understood. Human milk oligosaccharides (HMOs) are complex sugars produced by the mammary gland and present in variable amounts in different breast milks. Animal models show HMOs impact on development of NEC and human
preterm infant studies show a specific HMO, called
disialyllacto-N-tetraose (DSLNT), is present in maternal milk in lower amounts in infants who go on to develop NEC. This article reviews the role of HMOs in NEC development and the clinical data in preterm infants, and considers the possible next steps for supplementation in preterm infants.