Predisposing conditions for bacterial meningitis in children: what radiologists need to know

Area of Science:

• Pediatric Radiology
• Neuroradiology
• Infectious Diseases

Background:

• Bacterial meningitis (BM) in infants and children can stem from various underlying diseases.
• Predisposing conditions are broadly categorized into adjacent tissue infection spread to cerebrospinal fluid (CSF) and immunodeficiency.
• Understanding these conditions is crucial for appropriate imaging in BM management.

Purpose of the Study:

• To review the diagnostic imaging approaches for conditions predisposing to bacterial meningitis.
• To highlight the imaging findings associated with predisposing conditions of recurrent BM.
• To emphasize the role of radiology in managing patients with recurrent BM.

Main Methods:

• Computed tomography (CT) and magnetic resonance (MR) imaging are primary tools when structural defects are suspected.
• Radionuclide cisternography serves as a secondary method to pinpoint CSF leak sites.
• CT or MR imaging are utilized for parameningeal infections without structural defects to detect complications.

Main Results:

• Imaging strategies differ based on the presence or absence of a structural defect between the CSF space and adjacent tissues.
• CT and MR imaging effectively identify parameningeal infections (e.g., sinusitis, otitis media/mastoiditis) and associated intracranial complications.
• Radiology plays a key role in identifying predisposing factors and guiding management for recurrent BM.

Conclusions:

• Radiologists require knowledge of BM predisposing conditions for optimal patient care.
• Appropriate imaging selection, guided by suspected predisposing factors, is essential for diagnosis and management.
• Radiological assessment is vital for preventing recurrence and managing complications of bacterial meningitis.