Neonatal group A streptococcal meningitis and portal vein thrombosis: a casual association?

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie Vol. 21; no. 9; pp. 1020 - 1023
• Main Authors: Hmami, F, Oulmaati, A, Mahmoud, M, Boubou, M, Tizniti, S, Bouharrou, A
• Format: Journal Article
• Language: French
• Published: France 01-09-2014
• Subjects: Humans; Infant, Newborn; Male; Meningitis, Bacterial - microbiology; Portal Vein; Streptococcal Infections - diagnosis; Streptococcus pyogenes; Venous Thrombosis - diagnosis
• ISSN: 1769-664X
• DOI: 10.1016/j.arcped.2014.06.007

Invasive group A streptococcal infections are potentially serious. The occurrence in the neonatal period and meningeal location are two unusual situations. The complications reported in the literature vary; we add the risk of thromboembolic events. We report the case of a newborn, admitted to our department at 22 days of life for late neonatal group A streptococcal meningitis and diffuse cerebral infarction lesions. Ultrasound and abdominal CT scan objectified the presence of portal vein thrombosis and cavernoma. Echocardiography, electrocardiogram, as well as coagulation and thrombophilia tests were normal. Progression was marked by the installation of cerebral atrophy and ventricular dilation without the appearance of signs of portal hypertension over 18 months. We therefore concluded in neonatal group A streptococcal meningitis complicated by multiple thrombosis that can be explained by the invasive properties and hypercoagulability characterizing group A beta-hemolytic streptococcus. However, the characteristics of the fetal circulation may explain the possibility of paradoxical cerebral embolism from portal thrombosis.