title: Streptococcus pneumoniae meningoencephalitis with bilateral basal ganglia necrosis: an unusual complication due to vasculitis.
abstract: Streptococcus pneumoniae (S pneumoniae) is a common cause of bacterial meningitis, frequently leading to death or severe neurological impairment. We report an exceptional case of a 4-month-old boy with meningitis caused by S pneumoniae. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations of the brain showed bilateral symmetrical necrosis involving the lentiform and caudate nuclei, as well as the thalamus. T1-weighted MR images showed patchy areas of increased signal intensity, consistent with hemorrhagic transformation of the lesions. Autopsy revealed widespread necrosis of the basal ganglia with clear signs of vasculitis. Severe complications of S pneumoniae meningoencephalitis are known in infants but to our knowledge, such lesions in the basal ganglia have only been reported thrice in adults and never in children.
authors.affiliation: Department of (Pediatric) Critical Care Medicine, Antwerp University Hospital, University of Antwerp, Belgium.
authors.forename: Jessy
authors.initials: J
authors.lastname: Magnus
authors.forename: Paul M
authors.initials: PM
authors.lastname: Parizel
authors.forename: Berten
authors.initials: B
authors.lastname: Ceulemans
authors.forename: Patrick
authors.initials: P
authors.lastname: Cras
authors.forename: Marloes
authors.initials: M
authors.lastname: Luijks
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Jorens
mesh_terms: D001480:Basal Ganglia Diseases / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D008590:Meningoencephalitis / Q000150:complications / Q000209:etiology / Q000382:microbiology; D009336:Necrosis / Q000209:etiology / Q000821:virology; D011008:Pneumococcal Infections / Q000150:complications*; D013296:Streptococcus pneumoniae / Q000472:pathogenicity; D014057:Tomography, X-Ray Computed