Premature Labor and Neonatal Septicemia Caused by Capnocytophaga Ochracea

Patient: Female, 17-days-old Final Diagnosis: Cardiac arrest Symptoms: Lower abdominal pain and contractions Medication: — Clinical Procedure: Prematurity treatment and Management of neonatal septicemia Specialty: Pediatrics and Neonatology OBJECTIVE: Unknown ethiology BACKGROUND: Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and resistant to aminoglycosides. CASE REPORT: A 23-year-old woman presented with lower abdominal pain and was admitted for premature labor at 24-weeks of gestation. At presentation, the cervix was closed and the membrane was intact; however, contractions continued, the membrane subsequently ruptured before receiving any steroids or magnesium, and the mother gave birth to a 540-gram female baby. At birth, Apgar scores were 1 at 5 minutes, 1 at 10 minutes, and 2 at 15 minutes. On the fifth day of life, the blood culture grew Capnocytophaga species. Consequently, Cefotaxime was started and ampicillin continued for a total of 14 days; however, on the 6(th) day, the head ultrasound showed grade 4 intraventricular hemorrhage and a Do Not Resuscitate (DNR) order was placed in the chart. The patient’s health continued to deteriorate, having multiple episodes of bradycardia and desaturation until cardiac arrest on the 17(th) day. CONCLUSIONS: Capnocytophaga ochracea was isolated from the blood culture of a preterm neonate. It was thought to be the cause of the premature labor and subsequent neonatal septicemia. This case report suggests that the prevalence of Capnocytophaga infections is most likely underestimated and that additional premature labors and abortions could have been caused by Capnocytophaga infections that were never detected. Hence, more studies are needed to investigate the route of transmission.