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

Streptococcus bovis is a nonenterococcal, group D streptococcus, which frequently causes infections in immunocompromised adults and exceptionally cases of invasive infections in neonates, often caused by the variant 2 of the biotype II. It is important the correct microbiological identification because the treatment and prognostic are very different from other streptococcus.

We report a case of a 9-day-old neonate with sepsis and meningitis with seizures and intracranial bleeding, with CSF and blood isolation of S. bovis biotype I, with good response to ampicillin and cefotaxime treatment. This is the first case in our service and probably the first documented in the literature according to the bibliography review. We comment the most interesting aspects of the affection.

Streptococcus bovis is a recognized cause of bacteremia and endocarditis in adults, usually in association with gastrointestinal diseases. In contrast, this microorganism is a very infrequent cause of neonatal and pediatric infectious diseases. We report two cases of neonatal infection in which S. bovis (biotype II/2) was isolated from blood. The first patient presented with fever and gastrointestinal symptoms and recovered after antibiotic treatment. The second patient presented with respiratory distress. His course was fulminant and, in spite of therapy, he died 22 hours after birth. A review of the literature revealed only 27 previously reported cases of neonatal infection due to S. bovis in which this microorganism was isolated from blood. In this review, the infection appeared to be associated with a relatively good prognosis, but occasionally, as in the case of our second patient, the course can be rapid and fulminant and the outcome fatal.