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Cranial nerve palsies and cerebral infarction in a young infant with meningococcal meningitis

C H Chiu1, T Y Lin, Y C Huang

  • 1Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.

Scandinavian Journal of Infectious Diseases
|January 1, 1995
PubMed

Insights

This case report details a rare instance of meningococcal meningitis in a 30-day-old infant, complicated by cranial nerve palsies and cerebral infarction. Early diagnosis and treatment are crucial for managing severe neurological complications in neonates.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neonatology

Background:

  • Meningococcal meningitis, caused by Neisseria meningitidis, is a serious infection that can lead to severe complications.
  • While rare in neonates, meningococcal meningitis poses a significant risk for neurological sequelae.

Observation:

  • A 30-day-old infant presented with fever, lethargy, and poor feeding, progressing to meningitis confirmed by cerebrospinal fluid analysis.
  • Cranial nerve palsies (oculomotor and facial) and bilateral frontal lobe cerebral infarction were observed during hospitalization.
  • Neisseria meningitidis was identified in blood and cerebrospinal fluid samples.

Findings:

  • The infant received a 4-week course of intravenous penicillin for treated meningococcal meningitis.
  • Cerebrospinal fluid analysis revealed persistent high protein levels despite treatment.
  • Cerebral infarction in the bilateral frontal lobes was detected via computerized tomographic brain scan.

Implications:

  • This case highlights the potential for severe neurological complications, including cranial nerve palsies and cerebral infarction, in infant meningococcal meningitis.
  • Neonates with meningococcal meningitis face an elevated risk of neurological complications compared to older children.
  • Prompt recognition and aggressive management are essential to mitigate long-term neurological deficits in affected infants.

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