Comparison of CSF and MRI Findings among Neonates and Infants with E coli or Group B Streptococcal Meningitis
S.F. Kralik, M.K. Kukreja, M.J. Paldino, N.K. Desai and J.G. Vallejo
American Journal of Neuroradiology July 2019, DOI: https://doi.org/10.3174/ajnr.A6134
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Abstract
BACKGROUND AND PURPOSE: Group B Streptococcus and Escherichia coli (E coli) are the 2 most common causes of bacterial meningitis in neonates. The purpose of this study was to determine whether CSF and/or MR imaging findings differ between infants with group B streptococcal or E coli meningitis.
MATERIALS AND METHODS: A retrospective review was performed among neonates (younger than 28 days) and infants (younger than 120 days) with proved group B streptococcal (n = 57) or E coli meningitis (n = 50). A CSF or blood culture positive for Streptococcus or E coli and an elevated CSF white blood cell count were used as the criterion standard. Independent, blinded review of brain MRIs obtained within 21 days of presentation were performed by 2 board-certified neuroradiologists. CSF laboratory values and MR imaging findings were compared between the groups.
RESULTS: There was no statistically significant difference between the mean age at presentation for patients with group B streptococcal (40 days; range, 2–111 days) versus patients with E coli meningitis (31 days; range, 12–115 days) (P = .18). There was no statistically significant difference in the CSF white blood cell count, glucose, or protein. There was a significant difference between group B streptococcal and E coli meningitis in the frequency of hydrocephalus (0% versus 22%, P = .001) and infarct (40% versus 14%; P = .038), respectively. There was no statistically significant difference in leptomeningeal enhancement, cerebritis, ventriculitis, abscess/granuloma, subdural effusion, extra-axial purulent material, intraventricular purulent material, hemorrhage, and sinus thrombosis.
CONCLUSIONS: Although neonates and infants with group B streptococcal or E coli meningitis had similar age and CSF laboratory values, patients with group B streptococcal meningitis more frequently demonstrated infarcts, while those with E coli meningitis more frequently had early onset of hydrocephalus.
ABBREVIATIONS:
GBS
group B Streptococcus
WBC
white blood cell
Footnotes
Disclosures: Nilesh K. Desai—UNRELATED: Expert Testimony: multiple legal firms, Comments: expert review of cases. Jesus G. Vallejo—UNRELATED: Royalties: Wolters Kluwer, Comments: UptoDate chapters.
© 2019 by American Journal of Neuroradiology
S.F. Kralik, M.K. Kukreja, M.J. Paldino, N.K. Desai and J.G. Vallejo
American Journal of Neuroradiology July 2019, DOI: https://doi.org/10.3174/ajnr.A6134
ArticleFigures & DataInfo & MetricsReferences PDF
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
BACKGROUND AND PURPOSE: Group B Streptococcus and Escherichia coli (E coli) are the 2 most common causes of bacterial meningitis in neonates. The purpose of this study was to determine whether CSF and/or MR imaging findings differ between infants with group B streptococcal or E coli meningitis.
MATERIALS AND METHODS: A retrospective review was performed among neonates (younger than 28 days) and infants (younger than 120 days) with proved group B streptococcal (n = 57) or E coli meningitis (n = 50). A CSF or blood culture positive for Streptococcus or E coli and an elevated CSF white blood cell count were used as the criterion standard. Independent, blinded review of brain MRIs obtained within 21 days of presentation were performed by 2 board-certified neuroradiologists. CSF laboratory values and MR imaging findings were compared between the groups.
RESULTS: There was no statistically significant difference between the mean age at presentation for patients with group B streptococcal (40 days; range, 2–111 days) versus patients with E coli meningitis (31 days; range, 12–115 days) (P = .18). There was no statistically significant difference in the CSF white blood cell count, glucose, or protein. There was a significant difference between group B streptococcal and E coli meningitis in the frequency of hydrocephalus (0% versus 22%, P = .001) and infarct (40% versus 14%; P = .038), respectively. There was no statistically significant difference in leptomeningeal enhancement, cerebritis, ventriculitis, abscess/granuloma, subdural effusion, extra-axial purulent material, intraventricular purulent material, hemorrhage, and sinus thrombosis.
CONCLUSIONS: Although neonates and infants with group B streptococcal or E coli meningitis had similar age and CSF laboratory values, patients with group B streptococcal meningitis more frequently demonstrated infarcts, while those with E coli meningitis more frequently had early onset of hydrocephalus.
ABBREVIATIONS:
GBS
group B Streptococcus
WBC
white blood cell
Footnotes
Disclosures: Nilesh K. Desai—UNRELATED: Expert Testimony: multiple legal firms, Comments: expert review of cases. Jesus G. Vallejo—UNRELATED: Royalties: Wolters Kluwer, Comments: UptoDate chapters.
© 2019 by American Journal of Neuroradiology
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