Streptococcus pneumoniae meningoencephalitis with unusual and widespread white matter lesions

Philippe G. Jorens, Paul M. Parizel, Marek Wojciechowski, Annick Laridon, Annick De Weerdt, Geert Mertens, Berten Ceulemans

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Abstract

Streptococcus pneumoniae is a common cause of bacterial meningitis, frequently leading to death or severe neurological impairment. We report an exceptional case of a 7-month-old child with meningoencephalitis caused by S. pneumoniae. Peculiar, widespread and unique signal abnormalities were found on magnetic resonance imaging (MRI) with extensive central nervous white matter injury as well as evidence of thrombosis of the lateral transverse sinus. These changes were observed very early in the course of the illness, presumably reflecting widespread cytotoxic edema, vasculitis and acute demyelination. These lesions occurred despite appropriate antibiotic and anti-inflammatory (glucocorticoid) therapy started very early in the course of the disease. Such diffuse white matter lesions in the early course of (pediatric) cases of S. pneumoniae meningoencephalitis have not been reported previously (C) 2007 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)127-132
Number of pages6
JournalEuropean Journal of Paediatric Neurology
Volume12
Issue number2
DOIs
Publication statusPublished - Mar 2008
Externally publishedYes

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