Introduction: The infection of a cephalohematoma is an infrequente but potentially fatal condition due to its possible complications such as osteomyelitis, meningitis or sepsis.

Case report: The report describes a newborn delivered by cesarean section, and a history of duodenal atresia with surgical correction, who develops, at 8 days of life, an infection of a cephalohematoma with sepsis and meningitis. After aspiration of the cephalohematoma and a three week course of antibiotics, she showed a favorable outcome.

Conclusion: When the infection of a cephalohematoma is suspected, its drainage is both a diagnostic and therapeutic tool, as antibiotic therapy alone is often insufficient. Possible complications such as meningitis, osteomyelitis and sepsis must be ruled out.

C. Cortés Ledesma. Departamento de Neonatología. Hospital General Universitario Gregorio Marañón. Dr. Esquerdo, 46. 28007 Madrid.
Correo electrónico: crispucortes@gmail.com

Objective: To study the rate of bacterial meningitis among infants aged 0-3 months with suspicion of urinary tract infection.

Methods: This retrospective chart review involved all children younger than 3 months with pathologic rapid urine testing by urethral catheterization in the emergency department. Lumbar puncture was performed in all children <1 month and every child 1-3 months with septic appearance. The study was conducted from October 2004 to July 2010.

Results: The study sample included 290 children with suspicion of urinary tract infection, of whom 76% boys and 24% girls; 43% of all patients were younger than one month. Urinary tract infection was confirmed by positive urine culture in 230 children, 9 of whom (3.2%) had bacteraemia associated. Lumbar puncture was performed on 167 patients (58%), of whom 7 (4%) had CSF pleocytosis. All CSF cultures were negative except of a case of a neonate 24 days old with meningitis and urinary tract infection caused by Escherichia coli.

Conclusions: The incidence of bacterial meningitis among infants aged 0-3 months with suspicion of urinary tract infection was 0.6% in our study. It is important to reconsider the performance of lumbar puncture systematically in these children, although it is still need in children aged less than 1 month and in cases where there is clinical or laboratory test suspicion of serious bacterial infection.

Enteroviral meningitis is uncommon in the newborn infant. It may be underdiagnosed because the usual laboratory tests, except that performed in cerebrospinal fluid, may be normal. Two new cases in newborn infants are reported.

Ventriculitis is an infrequent cerebral infection that may result from the extension of meningitis inside the ventricles. The purpose of this case study is to describe the features of Diffusion-Weighted MR imagining of pyogenic ventriculitis in an unweaned baby. Markedly increased signal intensity of dependent intraventricular fluid on Diffusion-Weighted MR suggests the diagnosis of pyogenic ventriculitis.