Cerebral infarction in perinatal and childhood bacterial meningitis

Chang, Cheng-Jong; Chang, Wen-Neng; Huang, Laura; Chang, Ying-Chao; Huang, Song‐Chei; Hung, Po-Cheng; Ho, Hirzel; Chang, Chin-Jung; Wang, K.-W.; Cheng, Ben-Chung; Lui, Chun‐Chung; Chang, Hsueh‐Wen; Lu, Cheng-Hsien

doi:10.1093/qjmed/hcg128

Cited by 57 publications

(31 citation statements)

References 22 publications

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“…21 In the past, H influenzae type b has been an important cause of meningitis associated with a greater mortality (25%) than other bacterial meningitis, particularly when complicated with cerebral infarction 22 ; however, in countries in which the conjugate vaccine is used routinely, H influenzae meningitis has essentially disappeared. 21 Chang et al 19 identified S pneumoniae and Salmonella species as the most common causes in children sustaining bacterial meningitis and cerebral infarction within the first year of life. Salih et al 23 reported that H influenzae, S pneumoniae, and S aureus were the most frequent causes of meningitis with subsequent cerebral infarction in Saudi Arabian children age 5-21 months.…”

Section: Meningoencephalitides Complicated With Infectious Vasculitismentioning

confidence: 99%

Acute Ischemic Stroke and Infections

Ionita

Siddiqui

Levy

et al. 2011

Journal of Stroke and Cerebrovascular Diseases

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Section: Meningoencephalitides Complicated With Infectious Vasculitismentioning

confidence: 99%

Acute Ischemic Stroke and Infections

Ionita

Siddiqui

Levy

et al. 2011

Journal of Stroke and Cerebrovascular Diseases

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“…Arterial ischemic stroke, CSVT, and intracranial hemorrhage are all known complications of pneumococcal meningitis in children 1,[13][14][15] and in adults, 18 and portend a worse prognosis. 16,17 Our 2 cases of vaccinated children with pneumococcal meningitis due to non-PCV13 serotypes highlight its spectrum of cerebrovascular disease and morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Stroke and meningitis are frequently comorbid; before the introduction of PCV7, strokes were discovered in 10% to 27% of children with acute bacterial meningitis. [13][14][15] Some small studies suggest S pneumoniae infection is more commonly associated with stroke relative to other pathogens, 13,15 although others found no association.…”

mentioning

confidence: 99%

Cerebrovascular Complications of Pediatric Pneumococcal Meningitis in the PCV13 Era

Bernson-Leung

Lehman

2016

Hospital Pediatrics

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A previously healthy, full-term 5-month-old girl presented to the emergency department with a 1-day history of fever to 103°F, emesis, poor feeding, and progressive lethargy. She had recently started day care. The patient had received her routine 2-and 4-month childhood vaccines on schedule, including the 13-valent pneumococcal conjugate vaccine (PCV13). Initial examination revealed decreased responsiveness, rightward gaze preference, decreased movement of the left side, and positive Brudzinski sign. Laboratory testing is as in Table 1. Ceftriaxone and vancomycin were started at meningitic dosing. Cerebrospinal fluid grew Streptococcus pneumoniae serotype 33F, a nonvaccine serotype. Case 2A previously healthy 21-month-old boy presented to the emergency department with a 1-day history of fever to 103°F, emesis, cough, and lethargy. Rapid influenza testing was positive for influenza A, and oseltamivir was started. History was notable for day care attendance and multiple sick contacts. He was fully immunized, including PCV13.The next morning, he had a brief seizure with eye deviation and generalized convulsions, and became obtunded. Simultaneously, blood culture grew gram-positive cocci in pairs and chains. He returned to the emergency department, where he had right-sided weakness, posturing, rightward eye deviation, and meningismus as well as further seizures requiring lorazepam and fosphenytoin. Laboratory testing is as in Table 1. Ceftriaxone and vancomycin were started at meningitic dosing. Cerebrospinal fluid grew S pneumoniae serotype 15B, a nonvaccine serotype.

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“…Strokes in children also result in significant morbidity as > 50% of survivors will have cognitive or motor disabilities [2,3]. Little attention has been paid to strokes that occur in children who are already critically ill. Serious systemic illnesses, such as meningitis and underlying malignancy, are well-known risk factors for stroke in childhood [4,5]. We hypothesized that mortality among pediatric stroke patients increases when critical illness precedes stroke.…”

Section: Introductionmentioning

confidence: 99%

Ischemic Stroke in Children with Critical Illness: A Poor Prognostic Sign

Jordan¹,

Beek²,

Gottesman³

et al. 2007

Pediatric Neurology

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A consecutive case series of 55 children (0-17 years old) with arterial ischemic stroke is reported. Twenty of these children were critically ill at the time their stroke occurred. Mortality among these 20 children was 40%, as compared to 3% in non-critically ill children with arterial ischemic stroke; overall mortality in this case series was 16%. Mortality resulted primarily from the underlying illness. Prognosis after stroke is markedly worsened in children with premorbid critical illness.

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Cerebral infarction in perinatal and childhood bacterial meningitis

Cited by 57 publications

References 22 publications

Acute Ischemic Stroke and Infections

Acute Ischemic Stroke and Infections

Cerebrovascular Complications of Pediatric Pneumococcal Meningitis in the PCV13 Era

Ischemic Stroke in Children with Critical Illness: A Poor Prognostic Sign

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