Complicated Pneumococcal Meningitis in a Fully Vaccinated Child: Value of Magnetic Resonance Imaging Monitoring

S. Ilia; A.-M. Spanaki; M. Raissaki; V. I. Spoulou; M.-D. Fitrolaki; M. Kanariou; G. Tzanakaki; G. Briassoulis

doi:10.1055/s-0031-1295407

Neuropediatrics, Table of Contents

Neuropediatrics 2011; 42(06): 240-244
DOI: 10.1055/s-0031-1295407

Short Communication

Complicated Pneumococcal Meningitis in a Fully Vaccinated Child: Value of Magnetic Resonance Imaging Monitoring

Authors

S. Ilia

¹Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
A.-M. Spanaki

¹Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
M. Raissaki

²Department of Radiology, University Hospital of Heraklion, Heraklion, Crete, Greece
V. I. Spoulou

³1st Department of Pediatrics, Division of Infectious Diseases ‘Aghia Sophia’ Children’s Hospital, Athens University School of Medicine, Athens, Greece
M.-D. Fitrolaki

¹Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
M. Kanariou

⁴Department of Immunology – Histocompatibility, “Aghia Sophia” Children’s Hospital, Athens, Greece
G. Tzanakaki

⁵National Meningitis Reference Laboratory, National School of Public Health, Athens, Greece
G. Briassoulis

¹Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece

Abstract

We present a unique case of life-threatening pneumococcal meningitis complicated by vasculitis in a fully vaccinated 4-year-old female with the heptavalent conjugate vaccine for Streptococcus pneumoniae (PCV7). Serotype 23F was isolated in both blood and cerebral spinal fluid (CSF) samples. Pulses of methylprednisolone were promptly initiated in addition to antibiotics leading to a good recovery. CSF studies and magnetic resonance imaging (MRI) of the brain were used for diagnosis and monitoring the response to corticoid therapy. We report the investigations of a child with failure of PCV7 vaccine to protect against vaccine-serotype invasive disease. Use of corticosteroids and temporal association with changes in brain imaging are described for the first time in literature.

Key words

meningitis - magnetic resonance imaging - pulse of steroids - vasculitis - Streptococcus pneumonia - PCV7

Full Text

References

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