Comparison of CSF and MRI Findings among Neonates and Infants with E coli or Group B Streptococcal Meningitis

• Published in: American journal of neuroradiology : AJNR Vol. 40; no. 8; pp. 1413 - 1417
• Main Authors: Kralik, S F, Kukreja, M K, Paldino, M J, Desai, N K, Vallejo, J G
• Format: Journal Article
• Language: English
• Published: United States American Society of Neuroradiology 01-08-2019
• Subjects: Brain Infarction - epidemiology; Brain Infarction - etiology; Escherichia coli Infections - cerebrospinal fluid; Escherichia coli Infections - diagnostic imaging; Female; Humans; Hydrocephalus - diagnostic imaging; Hydrocephalus - etiology; Infant, Newborn; Leukocyte Count; Magnetic Resonance Imaging; Male; Meningitis, Bacterial - cerebrospinal fluid; Meningitis, Bacterial - complications; Meningitis, Bacterial - diagnostic imaging; Pediatrics; Retrospective Studies; Streptococcal Infections - cerebrospinal fluid; Streptococcal Infections - diagnostic imaging; Streptococcus agalactiae
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A6134

Group B
and
(
) are the 2 most common causes of bacterial meningitis in neonates. The purpose of this study was to determine whether CSF and/or MR imaging findings differ between infants with group B streptococcal or
meningitis.
A retrospective review was performed among neonates (younger than 28 days) and infants (younger than 120 days) with proved group B streptococcal (
= 57) or
meningitis (
= 50). A CSF or blood culture positive for
and an elevated CSF white blood cell count were used as the criterion standard. Independent, blinded review of brain MRIs obtained within 21 days of presentation were performed by 2 board-certified neuroradiologists. CSF laboratory values and MR imaging findings were compared between the groups.
There was no statistically significant difference between the mean age at presentation for patients with group B streptococcal (40 days; range, 2-111 days) versus patients with
meningitis (31 days; range, 12-115 days) (
= .18). There was no statistically significant difference in the CSF white blood cell count, glucose, or protein. There was a significant difference between group B streptococcal and
meningitis in the frequency of hydrocephalus (0% versus 22%,
= .001) and infarct (40% versus 14%;
= .038), respectively. There was no statistically significant difference in leptomeningeal enhancement, cerebritis, ventriculitis, abscess/granuloma, subdural effusion, extra-axial purulent material, intraventricular purulent material, hemorrhage, and sinus thrombosis.
Although neonates and infants with group B streptococcal or
meningitis had similar age and CSF laboratory values, patients with group B streptococcal meningitis more frequently demonstrated infarcts, while those with
meningitis more frequently had early onset of hydrocephalus.