Subdural Empyema Caused by Neisseria meningitidis

Ray, Stephen; Riordan, Andrew; Tawil, Mohamed; Mallucci, Conor; Jauhari, Praveen; Solomon, Tom; Kneen, Rachel

doi:10.1097/inf.0000000000001252

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…Similar cases of cerebral abscess or subdural empyema complicating serogroup B meningococcal meningitis are rare (Additional file 1). Rothbaum et al reported successful antimicrobial treatment and surgical drainage of cerebral abscess in an area of left temporal lobe hypoperfusion in a previously healthy 5-month old with serogroup B meningococcal septic shock [5]. And more recently, multiple cerebral abscesses were reported in association with serogroup B meningococcal meningitis in a five-day old neonate in India [6].…”

Section: Discussionmentioning

confidence: 99%

“…Invasive meningococcal disease (IMD) presenting with meningitis causes significant mortality, with a 10% case fatality rate in the very young, and morbidity in up to 20% of survivors, predominantly neurological sequelae (seizures, cognitive impairment), visual and/or auditory impairment and amputation of necrotic digits and/or limbs [3]. By contrast, acute suppurative complications of N. meningitidis meningitis occur in less than 1% of cases and are rarely reported [4, 5]. We report the successful treatment of multiple cerebral abscesses associated with serogroup B meningococcal meningitis in a young infant with a prior cerebral infarct and complex medical history.…”

Section: Introductionmentioning

confidence: 99%

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A case report of multiple cerebral abscess formation complicating serogroup B Neisseria meningitidis meningitis

et al. 2019

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Background Invasive meningococcal disease (IMD) presenting with meningitis causes significant mortality and morbidity. Suppurative complications of serogroup B meningococcal sepsis are rare and necessitate urgent multidisciplinary management to mitigate long-term morbidity or mortality. Case presentation We present a rare case of invasive meningococcal disease in a 28-month old boy complicated by multiple abscess formation within a pre-existing antenatal left middle cerebral artery territory infarct. Past history was also notable for cerebral palsy with right hemiplegia, global developmental delay and West syndrome (infantile spasms). Two craniotomies were performed to achieve source control and prolonged antimicrobial therapy was necessary. The patient was successfully discharged following extensive multidisciplinary rehabilitation. Conclusions Longstanding areas of encephalomalacia in the left MCA distribution may have facilitated the development of multiple meningococcal serogroup B abscess cavities in the posterior left frontal, left parietal and left temporal lobes following an initial period of cerebritis and meningitis. A combination of chronic cerebral hypoperfusion and some degree of pre-existing necrosis in these areas, may also have facilitated growth of Neisseria meningitidis, leading ultimately to extensive cerebral abscess formation following haematogenous seeding during meningococcemia. In this case report we review similar cases of cerebral abscess or subdural empyema complicating serogroup B meningococcal meningitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%