Case report and literature study on the resolution of Neonatal Mycoplasma hominis meningitis with non-specific therapy

Background Mycoplasma hominis primarily inhabits in the human urogenital tract. Pregnant women can transmit it to their newborns during delivery, posing potential risks to both full-term and preterm infants. In severe cases, it can even cause neonatal Mycoplasma hominis meningitis. Case presentation: We reported a case of Mycoplasma hominis meningitis in a premature infant. Azithromycin treatment was administered due to a positive amniotic fluid culture for Mycoplasma hominis. On the 13th day after birth, the infant exhibited tachycardia and decreased blood pressure, and was assisted with invasive ventilation. After blood and cerebrospinal fluid (CSF) cultures were sent for examination, meropenem and vancomycin were administered for anti-infection treatment. CSF analysis revealed a predominance of polynuclear leukocytes, and no bacterial growth was found in blood and CSF cultures. The infant was transferred to our hospital on the same day with fever, and was treated with meropenem, vancomycin, and azithromycin. After three days of hospitalization, the infant's body temperature returned to normal, and vancomycin was discontinued. The infant's clinical symptoms gradually improved, and the number of white blood cells in the CSF gradually decreased. On the 19th day, the infant had frequent episodes of apnea, and high-throughput sequencing of pathogenic microbial nucleic acid in CSF detected Mycoplasma hominis. On the 20th day, meropenem was discontinued, and azithromycin was continued for a total of 21 day. The infant was discharged in good condition, with no obvious neurological complications or sequelae. Conclusions We report a case of Mycoplasma hominis meningitis in a premature infant that was successfully treated with azithromycin. A review of the literature revealed that Mycoplasma hominis meningitis in neonates may have a favorable prognosis with non-specific treatment under certain conditions.