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Brain magnetic resonance imaging of infants with bacterial meningitis

Carlos R Oliveira1, Michael C Morriss2, John G Mistrot1

  • 1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX; Children's Medical Center, Dallas, TX.

The Journal of Pediatrics
|April 15, 2014
PubMed
Abstract

Insights

Brain magnetic resonance imaging (MRI) is frequently abnormal in infants with bacterial meningitis, revealing common issues like leptomeningeal enhancement and cerebral infarcts. These findings often alter clinical management and neurosurgical intervention decisions.

Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Infectious Diseases

Background:

  • Bacterial meningitis in infants poses significant neurological risks.
  • Early and accurate diagnosis is crucial for effective management.
  • Brain magnetic resonance imaging (MRI) plays a role in assessing complications.

Purpose of the Study:

  • To evaluate the diagnostic yield of brain MRI in infants with bacterial meningitis.
  • To determine how MRI findings influence clinical management decisions.
  • To identify common MRI abnormalities associated with infant bacterial meningitis.

Main Methods:

  • Retrospective review of infants (<12 months) with culture-confirmed bacterial meningitis and brain MRI.
  • Exclusion of infants with shunts or skin commensal contaminants.
  • Independent neuroradiologist review of all MRI studies.

Main Results:

  • 68% of enrolled infants underwent brain MRI, with 81% showing abnormalities.
  • Common MRI findings included leptomeningeal enhancement (57%), subdural empyema (52%), and cerebral infarct (43%).
  • Abnormal MRI findings correlated with late seizures and abnormal neurologic exams, and led to neurosurgical intervention in 23% of cases.

Conclusions:

  • Brain MRI is frequently performed and often reveals significant abnormalities in infants with bacterial meningitis.
  • MRI findings frequently impact clinical management, including the need for neurosurgical intervention.
  • A notable percentage of infants with bacterial meningitis had normal brain MRI findings.

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