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Patterns of complications of neonatal and infant meningitis on MRI by organism: A 10 year review.
MedLine Citation:
PMID:  21067879     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Imaging of meningitis in neonates and infants is not routine, but is frequent for complications. Aside from tuberculosis and herpesvirus, imaging findings related to most responsible pathogens are thought to be nonspecific, but few studies exist. We reviewed the imaging features of complicated meningitis in infants and neonates at our hospital in the past decade, hypothesizing that patterns of complications might be more specific than previously recognized.
METHODS: 10 yr retrospective review of magnetic resonance imaging (MRI) and microbiology data for all neonates (age <30 d) and infants (age <1 yr) imaged for possible complications of meningitis at a tertiary children's hospital.
RESULTS: We had 63 patients (25 neonates, 38 infants). The 3 most common pathogens were streptococcal species (n=32, mean age 4.7 mo), E. coli (n=9, mean 1.2 mo), and herpes simplex virus (n=4). The most common findings were meningeal enhancement (78% of those given IV contrast), infarct (52%), subdural collection (35%), and ventriculomegaly (32%). E. coli presented much more frequently with ventriculomegaly (64% vs. 22%) than streptococcal species. Extensive infarcts were typical of streptococcal meningitis (13/32, 41%) and rarely seen with other organisms (2/31, 6%, p=0.001). All 3 cases of Serratia meningitis had large parenchymal abscesses, and 2/4 cases of meningococcus had occipital cortical necrosis.
CONCLUSION: Although overlap was present, each organism responsible for neonatal/infant meningitis produced an identifiable pattern of complications on MRI. Recognising these patterns can help the radiologist suggest possible diagnosis and influence early management.
Authors:
Jacob L Jaremko; Anna S Moon; Surekha Kumbla
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Publication Detail:
Type:  Journal Article     Date:  2010-11-10
Journal Detail:
Title:  European journal of radiology     Volume:  80     ISSN:  1872-7727     ISO Abbreviation:  Eur J Radiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  821-7     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Medical Imaging, Royal Children's Hospital, 2nd floor, Main Block Flemington Rd., Parkville, VIC 3052, Australia.
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