Recurrent bacterial meningitis in children role of imaging

ABSTRACT

Recurrent bacterial meningitis may be the consequence of immune deficiency or result from anatomic abnormalities which provide portals of entry of infection into the central nervous system. Bacterial migration along congenital or acquired pathways from the skull or spinal dural defects gain entrance into the CNS and should be taken into consideration when children face recurrent bacterial meningitis. Assess the role of imaging in children with recurrent bacterial meningitis 10 children with Recurrent bacterial meningitis were included in this study. They were 8 males and 2 females. Their age ranged from 2-16 years. All patients were subjected to CT scan for brain and skull base. CT metrizamide was done in 7 cases, cranial MRI in 3 cases and spinal MRI in one case. Cranial dural defects were found in 9 cases. These defects were traumatic [3 cases], congenital [4], chronic increased intracranial pressure [1] and in 1 case we were not able to identify the exact nature either congenital or acquired. One child has spinal dural defect due to congenital dermal sinus of the lumbar spine. Among the helical CT scanners used in this study [single, 4 and 64 slices], the 64-slice scanner was very sensitive to small cranial dural defects while CF metrizamide was sensitive and specific for defect localization. Recurrent bacterial meningitis should prompt a search for an underlying cranial or spinal anatomic detects especially in the absence of immunodeficiency conditions