Late-Onset Group B Streptococcal Meningitis Has Cerebrovascular Complications

Tibussek, Daniel; Sinclair, Adriane; Yau, Ivanna; Teatero, Sarah; Fittipaldi, Nahuel; Richardson, Susan E.; Mayatepek, Ertan; Jahn, P.; Askalan, Rand

doi:10.1016/j.jpeds.2015.02.014

Cited by 55 publications

(42 citation statements)

References 17 publications

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“…Other studies used a similar MRI classification as in this study . The prevalence of lesions is largely in accordance with literature on GBS meningitis (81–93%) . A wide range of structural anomalies on MRIs caused by GBS meningitis have been reported in the literature with the following being the most prevalent: leptomeningeal enhancement (57–78%) , infarcts (41–93%) , basal ganglia involvement (47%) and subdural empyema (32–52%) .…”

Section: Discussionsupporting

confidence: 79%

“…The prevalence of lesions is largely in accordance with literature on GBS meningitis (81–93%) . A wide range of structural anomalies on MRIs caused by GBS meningitis have been reported in the literature with the following being the most prevalent: leptomeningeal enhancement (57–78%) , infarcts (41–93%) , basal ganglia involvement (47%) and subdural empyema (32–52%) . Other less frequently reported lesions in the literature were as follows: hydrocephalus, ventriculitis, epidural and, or, parenchymal abscess, vasogenic or cytotoxic brain oedema and sinovenous thrombosis (6–12.5%) .…”

Section: Discussionsupporting

confidence: 78%

“…Tibussek et al. also reported similar results (43% abnormal outcome), albeit at a much shorter follow‐up mean time of 17 months. The reported figures in the two studies mentioned above are more in agreement with our findings.…”

Section: Discussionmentioning

confidence: 57%

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Brain imaging can predict neurodevelopmental outcome of Group B streptococcal meningitis in neonates

et al. 2018

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Aim: The association between cranial ultrasound (CUS) or magnetic resonance imaging (MRI) lesions and neonatal Group B streptococcal (GBS) meningitis outcome has not been studied in detail.Methods: This retrospective study assessed CUS, cranial MRI and neurodevelopmental outcome in 50 neonates with GBS meningitis admitted to three neonatal intensive care units in the Netherlands between 1992 and 2014. Death, cognitive outcome and motor outcome below À1 SD were considered as adverse outcomes.Results: CUS was available in all and MRIs in 31 infants (62%) with 28 CUS (56%) and27 MRIs (87%) being abnormal. MRI lesions were multifocal (n = 10, 37%), bilateral (n = 22; 82%) and extensive (n = 11; 41%). A total of 10 died in the neonatal period. Median age at assessment was 24 months. Among survivors, abnormal cognitive outcome and motor outcome were seen in 23 and 20 patients, respectively. Abnormal CUS [odds ratio (OR) 5.3, p = 0.017], extensive bilateral deep grey lesions (OR 6.7, p = 0.035) and white matter lesions (OR 14.0, p = 0.039) correlated with abnormal motor outcome. Extensive bilateral deep grey matter lesions correlated with abnormal cognitive outcome (OR 8.1, p = 0.029).Conclusion: Abnormal CUS and the most severely affected MRIs were associated with poor neurodevelopmental outcome in neonatal GBS meningitis.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 78%

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Brain imaging can predict neurodevelopmental outcome of Group B streptococcal meningitis in neonates

et al. 2018

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“…20,21,35 However, the pattern of our DWI findings differed from the large territorial cerebral infarction and vasculitic narrowing of the major intracranial arteries detected on MR angiography previously described in neonatal GBS. [17][18][19]23 The relationship between CNS infections and acute ischemic stroke is complex, 33,34 and alternative explanations for MRI findings other than cerebral infarction, including cerebritis from direct infection by bacterial invasion, also need to be considered. 24,36 The cerebellar MRI findings in our patients are also unusual for CNS infection: they did not correlate with clinical features and are difficult to characterize.…”

Section: Discussionmentioning

confidence: 99%

“…9 Although there is recent recognition that this organism is a cause of substantial morbidity and mortality among patients with chronic underlying conditions, such as diabetes mellitus, malignancy, neurologic disorders, and skin diseases, [10][11][12] these adults with invasive GBS infection and comorbidities typically suffered from urinary tract and soft tissue infection, osteomyelitis, infective endocarditis and pneumonia; only a minority had meningitis. [13][14][15][16][17][18][19] During the Singapore outbreak of GBS infection, an increased frequency and unusual manifestations were noticed during the prospective surveillance of acute CNS infections by the SNIP investigators and other physicians (T. Barkham and B. Ang, unpublished data). We describe here the clinical, laboratory, and neuroimaging features of a cluster of adults with CNS infections caused by GBS.…”

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confidence: 99%

Diffusion-weighted MRI abnormalities in an outbreak ofStreptococcus agalactiaeSerotype III, multilocus sequence type 283 meningitis

Tan

Wijaya

Chiew

et al. 2016

J. Magn. Reson. Imaging

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Host–pathogen interactions in bacterial meningitis

et al. 2016

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Bacterial meningitis is a devastating disease occurring worldwide with up to half of the survivors left with permanent neurological sequelae. Due to intrinsic properties of the meningeal pathogens and the host responses they induce, infection can cause relatively specific lesions and clinical syndromes that result from interference with the function of the affected nervous system tissue. Pathogenesis is based on complex host–pathogen interactions, some of which are specific for certain bacteria, whereas others are shared among different pathogens. In this review, we summarize the recent progress made in understanding the molecular and cellular events involved in these interactions. We focus on selected major pathogens, Streptococcus pneumonia, S. agalactiae (Group B Streptococcus), Neisseria meningitidis, and Escherichia coli K1, and also include a neglected zoonotic pathogen, Streptococcus suis. These neuroinvasive pathogens represent common themes of host–pathogen interactions, such as colonization and invasion of mucosal barriers, survival in the blood stream, entry into the central nervous system by translocation of the blood–brain and blood–cerebrospinal fluid barrier, and induction of meningeal inflammation, affecting pia mater, the arachnoid and subarachnoid spaces.

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Late-Onset Group B Streptococcal Meningitis Has Cerebrovascular Complications

Cited by 55 publications

References 17 publications

Brain imaging can predict neurodevelopmental outcome of Group B streptococcal meningitis in neonates

Brain imaging can predict neurodevelopmental outcome of Group B streptococcal meningitis in neonates

Diffusion-weighted MRI abnormalities in an outbreak ofStreptococcus agalactiaeSerotype III, multilocus sequence type 283 meningitis

Host–pathogen interactions in bacterial meningitis

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