Spread of infection to Virchow-Robin spaces in a patient with Streptococcus pneumoniae meningitis

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Michael Gordon1, Hemant Parmar, Mohannad Ibrahim

  • 1Division of Neuroradiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.

Journal of Computer Assisted Tomography
|July 30, 2009
PubMed

Insights

This case study shows Streptococcus pneumoniae causing acute bacterial leptomeningitis in a child. The infection spread through Virchow-Robin spaces, forming microabscesses that resolved with antibiotic treatment.

Area of Science:

  • Pediatric neurology
  • Infectious diseases
  • Neuroimaging

Background:

  • Acute bacterial leptomeningitis is a serious central nervous system infection.
  • Streptococcus pneumoniae is a common causative agent in pediatric meningitis.
  • Understanding the neuroimaging manifestations is crucial for diagnosis and management.

Observation:

  • A pediatric case of Streptococcus pneumoniae leptomeningitis is detailed.
  • Infection extended along Virchow-Robin spaces into the brain parenchyma.
  • Multiple microabscesses were identified in the brain parenchyma.

Findings:

  • Initial magnetic resonance imaging revealed restricted diffusion in microabscesses, indicative of acute injury.
  • Follow-up magnetic resonance imaging demonstrated contrast enhancement and evolution of the microabscesses.
  • Complete resolution of microabscesses was achieved with antibiotic therapy.

Implications:

  • This case highlights the importance of recognizing imaging patterns of leptomeningitis extension.
  • Early diagnosis and appropriate antibiotic treatment are critical for favorable outcomes.
  • Virchow-Robin space involvement can lead to parenchymal microabscess formation in bacterial meningitis.

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