A 71-day-old 24 5/7-week gestation female infant in the NICU presents with right periauricular induration and erythema.

The infant was given endotracheal surfactant and placed on high-frequency jet ventilation. Blood and respiratory culture specimens were obtained and empiric antibiotics initiated. Respiratory culture was positive for Eikenella corrodens and placental pathology demonstrated necrotizing funisitis and chorioamnionitis. Antibiotics were switched to cefepime after sensitivities became available. At 8 days of age, she had an acute cardiopulmonary arrest in the setting of cardiac tamponade because of a hemorrhagic pericardial effusion. A pericardial pigtail catheter was placed and removed on day 12 with echocardiography demonstrating resolution of the effusion. Echocardiography also revealed a small ventricular septal defect and large patent ductus arteriosus, which was treated with 2 courses of indomethacin followed by acetaminophen. Respiratory support was weaned and the infant underwent extubation to continuous positive airway pressure on day 34. Central lines were removed...

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