Streptococcus pneumoniae Meningoencephalitis With Bilateral Basal Ganglia Necrosis

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.

Paroxysmal Autonomic Instability with Dystonia after Pneumococcal Meningoencephalitis

“…Basal ganglia are vulnerable for global and local ischemia and hypoxemia. However, Magnus et al (2011) reported on an infant with S. pneumoniae meningoencephalitis who had acute vasculitis, leading to unusual basal ganglia necrosis [10]. Jorens et al described in three adult patients (2005) and in one infant (2008) with pneumococcal meningoencephalitis widespread hyperintense lesions suggesting extensive central nervous parenchymal injury (predominantly the deep white matter) in the early course of the disease, presumably reflecting areas of ischemia with cytotoxic edema secondary to an immunologically mediated necrotizing vasculitis and thrombosis [9, 11].…”

“…It is associated with significant morbidity, longer length of stay in rehabilitation services, and less favorable functional outcomes [3]. In addition, S. pneumoniae meningoencephalitis is associated with high mortality rate and severe neurologic complications including hearing loss, hydrocephalus, ischemic brain injury, and seizures [10]. Our patient is deaf and has severe neurologic impairment and significant developmental delay despite rehabilitation therapies.…”

Biosensors for Monitoring Airborne Pathogens

“…Although the bacteria reside in the nasopharynx of healthy carriers, the bacteria cause infection when the immune system is compromised, and healthy individuals may experience severe complications such as endocarditis, cellulitis, and even brain abscess. [106][107][108][109] Even though more than 90 types have been isolated, 10 common serotypes account for more than 60% of the world's infectious bacterial diseases.…”

A case of fulminant pneumococcus meningoencephalitis progressing with white matter involvement despite two doses of conjugated pneumococcus vaccine

“…5 However, the extension of S. pneumonia infection to the parenchyma of the central nervous system (CNS) in adults and children has only rarely been reported. [5][6][7] In this report, we present a 6-month-old infant who developed. S. pneumoniae meningitis despite the administration of two doses of PCV and whose meningitis progressed rapidly and led to widespread damage in parenchymal brain tissue with the emergence of fulminant meningoencephalitis.…”