Note: White blood cell count (per dm³); Neutrophil percentage N%）; CRP, C-reactive protein (mg/ liter); Temperature (℃); White blood cell count (per dm³); Hb (g/liter); AST, Aspartate aminotransferase, (U/liter); CK-MB, Creatine kinase isoenzyme, (U/liter) ;*APTT, activated partial thromboplastin time(sec); Glu (mmol/liter); Lac (mmol/liter); BE (mmol/liter); bowel sounds(beats/min).

Forty-eight hours after birth, the infant’s skin was pale yellow and systemic edema was unchanged. Bowel sounds were weak. Mucus stools and a liquid dark area on abdominal ultrasound were observed (Table 1). Neonatal necrotizing enterocolitis was suspected, and we presume that it was caused by circulatory disturbances and secondary organ damage due to a severe congenital infection. To avoid serious multi-organ infection, circulatory failure, shock, and even death, a decision was made to administer imipenem/cilastatin as antimicrobial therapy.

Bacterial culture was still underway preliminary findings were suggestive of Listeria infection. Therefore, 62 hours after birth, the infant was given imipenem/cilastatin combined with intravenous amoxicillin sulbactam as antimicrobial therapy. Additional treatments administered included dopamine to improve circulation, an erythrocyte suspension to correct anemia, and parenteral nutrition. However, 70 hours after birth, the infant’s condition deteriorated and she gradually developed shortness of breath accompanied by a triple concave sign. The aspiration sounds of both lungs were symmetrical and scattered wet rales could be heard. Thirty minutes later, her anterior fontanel became slightly dilated and she developed meningitis symptoms including gazing, twitching of limbs, and clenching both fists. The infant was given intramuscular injections of phenobarbital for sedation and furosemide to reduce intracranial pressure. Her heart rate dropped to 60 beats/minute. Blood gas analysis showed a pH < 6.8. The infant died 72 hours after admission to the hospital. On the second day after her death, the results of blood culture and drug sensitivity tests confirmed L. monocytogenes infection.

In the mother, antimicrobial therapy was switched to piperacillin and sulbactam. After 40 hours, the mother’s temperature and blood cell counts returned to normal (Table 1).