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Multiple cerebral sinus thromboses complicating meningococcal meningitis: a pediatric case report
Elena Bozzola1, Mauro Bozzola, Giovanna Stefania Colafati
1Department of Pediatrics, Pediatric and Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. elena.bozzola@opbg.net.
BMC Pediatrics
|June 14, 2014
Summary
Cerebral venous sinus thrombosis (CVT) in children can be a serious complication of infection. Early diagnosis and thrombophilic evaluation are crucial for effective treatment and improved outcomes in pediatric CVT cases.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Pediatric Critical Care
Background:
- Cerebral venous sinus thrombosis (CVT) is a rare, potentially fatal condition in children, often presenting with non-specific symptoms leading to diagnostic delays.
- Meningococcal meningitis is a serious infection that can have severe neurological complications.
Observation:
- An 8-month-old boy with meningococcal meningitis initially showed normal CT scans but later developed irritability and lethargy.
- Contrast-enhanced CT revealed thrombosis in the superior sagittal, transverse, and rectus sinuses, indicating CVT.
Findings:
- The patient had hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR) variants (C677T and A1298C), indicating a hypercoagulable state.
- CVT can occur as a complication of infection, even with initially normal imaging.
Implications:
- Thrombophilic evaluation is recommended in pediatric CVT cases, even when an initial cause is identified.
- Prompt diagnosis and anticoagulation are vital for managing pediatric CVT and preventing severe outcomes.
- Increased physician awareness of CVT as a potential complication of infection is necessary for timely diagnosis.
