A 2-month-old girl with bifrontal/bitemporal meningococcal subdural empyema: complete radiological and clinical recovery after treatment.
This report describes a 2-month-old girl who developed a subdural empyema as a rare complication of meningococcal disease. The initial presentation was compatible with bacterial meningitis and sepsis and remarkable only for a lymphocytic pleocytosis of the cerebrospinal fluid (CSF), which was confirmed at a later occasion. After a week, when the patient continued to have fever, and subsequently developed focal seizure activity, MRI brain revealed a subdural empyema, necessitating craniectomy with a washout. Initial CSF and blood cultures were negative, but PCR analysis of the CSF from the primary lumbar puncture was positive for Neisseria meningitidis. She responded well to 6 weeks of intravenous meropenem and CT scan of the brain at the end of the treatment was normal. At 4-month follow-up, she was seizure-free with normal neurological examination and development.
Department of Neonates, Homerton University Hospital, London, UK. docarorap@gmail.com
Puneet Kumar
PK
Arora
Lesley
L
Alsford
D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000382:microbiology; D013354:Empyema, Subdural / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005625:Frontal Lobe; D006801:Humans; D007223:Infant; D008585:Meningitis, Meningococcal / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D011859:Radiography; D012074:Remission Induction; D013702:Temporal Lobe