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Diffusion-weighted imaging in acute bacterial meningitis in infancy

W Jan1, R A Zimmerman, L T Bilaniuk

  • 1Department of Radiology, Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA.

Neuroradiology
|August 9, 2003
PubMed

Insights

Diffusion-weighted imaging (DWI) detects complications in infants with bacterial meningitis. DWI identified multiple infarcts in 12 of 13 infants, highlighting its crucial role in managing this severe infection.

Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • Bacterial meningitis poses a significant risk of mortality and severe neurological deficits in infants.
  • Prompt identification and management of complications like vasculitis are critical for improving patient outcomes.

Observation:

  • This study investigated the utility of diffusion-weighted imaging (DWI) in identifying complications in 13 infants with bacterial meningitis who showed clinical deterioration despite treatment.
  • MRI, including DWI, was performed 2-5 days after presentation in infants aged 1 day to 32 months.

Findings:

  • Multiple infarcts, predominantly in the frontal lobes, were detected by DWI in 12 out of 13 infants.
  • Global brain involvement was observed in four infants, with three fatalities and one poor outcome.
  • DWI also aided in diagnosing subdural empyemas in one case and vasculitis in three of five patients assessed with MRA.

Implications:

  • Diffusion-weighted imaging is an essential component of MRI protocols for infants diagnosed with bacterial meningitis.
  • DWI can reveal subtle infarcts caused by septic vasculitis, which may be missed by conventional imaging, and differentiate empyemas from other abnormalities.

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