Ureaplasma urealyticum causes
infection or colonization of
female genital tracts associated with preterm delivery and
infertility and the
infection of the bloodstream,
respiratory tract, and
central nervous system in
infants, especially in prematures. We
report the first case of U. urealyticum
meningitis in a
premature infant in
Korea. She was born with a
birth weight of 1,481 gram at 32+3 weeks'
gestation and hospitalized for a respiratory care in the NICU in November 2005. Endotracheal aspirates and
urine cultures grew U. urealyticum at or = 10(4) CFU/mL of CSF. The
patient had a marked CSF
pleocytosis, low
glucose and high
protein content on the 13th
hospital day. CSF
cultures for ordinary
bacteria,
mycobacteria and
fungi remained negative. U. urealyticum was resistant to
erythromycin,
tetracycline,
ciprofloxacin and
pristinamycin, but susceptible to
doxycycline. Although she was treated with
erythromycin for 30 days, the organism was still isolated four times from the CSF with fluctuation of
C-reactive protein (CRP). After the addition of
chloramphenicol, CSF
cultures became negative in 3 days. However, CRP
rose again with increased
BUN at the 99th
hospital day, and she died on the 103rd
hospital day under the
diagnosis of a clinical
sepsis of unknown origin. In acute
meningitis of prematures already colonized with U. urealyticum, ureaplasmal
cultures and susceptibility test are warranted in
Korea.