<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3><p>In countries where Haemophilus influenzae type B vaccine is used, Streptococcus pneumoniae is the most common cause of bacterial meningitis in young children and notable cause of morbidity/mortality. The authors present material of magnetic resonance imaging (MRI) of patients with pneumococcal meningitis from archive of Department of Diagnostic Imaging of Institute of Mother and Child in Warsaw.</p></sec>
<sec><h3>Materials and methods</h3><p>We performed 27 brain MRI scans and 1 follow-up computed tomography (CT) in 10 children (2 girls and 8 boys) aged from neonate to 5 years at disease onset with proven pneumococcal infection.</p></sec>
<sec><h3>Results</h3><p>Follow-up period range was 0–12 years. Two children underwent only one MRI, one of them died before follow-up and the other was lost from further observation. There was one case of relatively benign disease course with mild changes on MRI. In another seemingly benign case, acute transient hydrocephalus was observed. Six children developed hydrocephalus, and two required ventriculoperitoneal shunting complicated by neuroinfection, shunt malfunction and revisions. Two patients developed epilepsy. In six children, spastic paresis of various severity was diagnosed, up to quadriplegia in one who is under the longest observation (>12 years) and survived in vegetative state. Three other children suffer from delayed psychomotor development to severe intellectual disability.</p></sec>
<sec><h3>Conclusions</h3><p>MRI shows perfectly the degree of central nervous system (CNS) damage during and after pneumococcal invasion. Despite appropriate treatment, disease course may be unpredictably serious. Attempts to eliminate the obligation to vaccinate are extremely irresponsible taking into account potential danger of death, vegetative state or another form of severe damage to CNS. Social and financial costs of care of survivors are very high with shunts placements and changes, (neuro)infections, rehabilitation, families breakdown, etc.</p></sec>
</abstract>

IntroductionIn countries where Haemophilus influenzae type B vaccine is used, Streptococcus pneumoniae is the most common cause of bacterial meningitis in young children and notable cause of morbidity/mortality. The authors present material of magnetic resonance imaging (MRI) of patients with pneumococcal meningitis from archive of Department of Diagnostic Imaging of Institute of Mother and Child in Warsaw.
Materials and methodsWe performed 27 brain MRI scans and 1 follow-up computed tomography (CT) in 10 children (2 girls and 8 boys) aged from neonate to 5 years at disease onset with proven pneumococcal infection.
ResultsFollow-up period range was 0–12 years. Two children underwent only one MRI, one of them died before follow-up and the other was lost from further observation. There was one case of relatively benign disease course with mild changes on MRI. In another seemingly benign case, acute transient hydrocephalus was observed. Six children developed hydrocephalus, and two required ventriculoperitoneal shunting complicated by neuroinfection, shunt malfunction and revisions. Two patients developed epilepsy. In six children, spastic paresis of various severity was diagnosed, up to quadriplegia in one who is under the longest observation (>12 years) and survived in vegetative state. Three other children suffer from delayed psychomotor development to severe intellectual disability.
ConclusionsMRI shows perfectly the degree of central nervous system (CNS) damage during and after pneumococcal invasion. Despite appropriate treatment, disease course may be unpredictably serious. Attempts to eliminate the obligation to vaccinate are extremely irresponsible taking into account potential danger of death, vegetative state or another form of severe damage to CNS. Social and financial costs of care of survivors are very high with shunts placements and changes, (neuro)infections, rehabilitation, families breakdown, etc.

Pneumococcal Meningitis and Its Sequelae – A Devastating CNS Disease

Clinic of Neurology of Children and Adolescents

Journal of Mother and Child

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Pneumococcal Meningitis and Its Sequelae \u2013 A Devastating CNS Disease"}

IntroductionIn countries where Haemophilus influenzae type B vaccine is used, Streptococcus pneumoniae is the most common cause of bacterial meningitis in...

Pneumococcal Meningitis and Its Sequelae – A Devastating CNS Disease

Article Category: Original Research Paper

Published Online: Jul 29, 2020

Page range: 13 - 18

DOI: https://doi.org/10.34763/jmotherandchild.2020241.2010.000009

Keywords
Streptococcus pneumoniae, meningitis, neurological sequelae, brain, magnetic resonance imaging

© 2020 Monika Bekiesińska-Figatowska et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Pneumococcal Meningitis and Its Sequelae – A Devastating CNS Disease

Article Category: Original Research Paper

Published Online: Jul 29, 2020

Page range: 13 - 18

DOI: https://doi.org/10.34763/jmotherandchild.2020241.2010.000009

KeywordsStreptococcus pneumoniae, meningitis, neurological sequelae, brain, magnetic resonance imaging

© 2020 Monika Bekiesińska-Figatowska et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
Streptococcus pneumoniae, meningitis, neurological sequelae, brain, magnetic resonance imaging