Abstract OBJECTIVE: To study the image characteristics of neonatal purulent meningitis caused by different pathogenic bacteria, using conventional magnetic resonance imaging (MRI). METHODS: The clinical data of 58 hospitalized newborns with purulent meningitis receiving MRI examination from January 2005 to February 2012 were retrospectively studied. Pathogens and MRI findings were investigated. RESULTS: Of the 58 newborns, 44 (76%) showed complications of the neural system on the first MRI. Escherichia coli were found as the most common pathogen in newborns with Gram-negative bacteria-induced purulent meningitis (six cases). Of the six cases, four presented with ventriculitis, one with subdural effusion and one with brain infarction on MRI. Listeria monocytogenes was frequently seen in newborns with Gram-positive bacteria-induced purulent meningitis (three cases). All three cases presented with different degrees of white matter damage on MRI. CONCLUSIONS: Neonatal purulent meningitis caused by different pathogenic bacteria has different image characteristics. This suggests that understanding the patterns of MRI findings is useful in the clinical diagnosis and treatment of neonatal purulent meningitis caused by different pathogens.
ZHANG Jing,MAO Jian,LI Juan et al. MRI findings of neonatal purulent meningitis caused by different pathogenic bacteria[J]. 中国当代儿科杂志, 2012, 14(07): 489-495.
ZHANG Jing,MAO Jian,LI Juan et al. MRI findings of neonatal purulent meningitis caused by different pathogenic bacteria[J]. CJCP, 2012, 14(07): 489-495.
［2］Thaver D, Zaidi AK. Burden of neonatal infections in developing countries: a review of evidence from community-based studies［J］. Pediatr Infect Dis J, 2009, 28(1 Suppl): S3-S9.
［3］Bentlin MR, Ferreira GL, Rugolo LM, Silva GH, Mondelli AL, Rugolo Junior A. Neonatal meningitis according to the microbiological diagnosis: a decade of experience in a tertiary center［J］. Arq Neuropsiquiatr, 2010, 68(6): 882-887.
［4］Garges HP, Moody MA, Cotten CM, Smith PB, Tiffany KF, Lenfestey R, et al. Neonatal meningitis: What is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters?［J］.J Pediatr, 2006, 117(4): 1094-1100.
［5］Smith PB, Garges HP, Cotton CM, Walsh TJ, Clark RH, Benjamin DK Jr. Meningitis in preterm neonates: importance of cerebrospinal fluid parameters［J］. Am J Perinatol, 2008, 25(7): 421-426.
［6］Hunter JV, Moryiss MC. Neuroimaging of central nervous system infections［J］. Semin Pediatr Infec Dis, 2003, 14(2): 140-164.
［7］Jaremko JL, Moon AS, Kumbla S. Patterns of complications of neonatal and infant meningitis on MRI by organism: a 10 year review［J］. Eur J Radiol, 2011, 80(3) :821-827.
［9］May M, Daley AJ, Donath S, Isaacs D; Australasian Study Group for Neonatal Infections. Early onset neonatal meningitis in Australia and New Zealand, 1992-2002［J］. Arch Dis Child Fetal Neonatal Ed, 2005, 90(4): F324-F327.
［10］Volpe JJ. Bacterial and fungal intracranial infections［M］//Volpe JJ. Neurology of The Newborn. 4th ed. London:WB Saunders, 2001: 774-810.
［12］Zaidi AK, Thaver D, Ali SA, Khan TA. Pathogens associated with sepsis in newborns and young infants in developing countries［J］. Pediatr Infect Dis J, 2009, 28(1 Suppl): S10-S18.
［13］Furyk JS, Swann O, Molyneux E. Systematic review: neonatal meningitis in the developing world［J］. Trop Med Int Health, 2011, 16(6): 672-679.
［15］Adams-Chapman I, Stoll BJ. Neonatal infection and long-term neurodevelopmental outcome in the preterm infant［J］. Curr Opin Infec Dis, 2006, 19(3): 290-297.
［16］Shah DK, Daley AJ, Hunt RW, Volpe JJ, Inder TE. Cerebral white matter injury in the newborn following escherichia coli meningitis［J］. Eur J Paediatr Neurol, 2005, 9(1): 13-17.
［17］Malik GK, Trivedi R, Gupta A, Singh R, Prasad KN, Gupta RK. Quantitative DTI assessment of periventricular white matter changes in neonatal meningitis［J］. Brain Dev, 2008, 30(5): 334-341.
［18］Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection［J］. JAMA, 2004, 292(19): 2357-2365.
［19］Back SA, Riddle A, McClure MM. Maturation-dependent vulenrability of perinatal white matter in premature birth［J］. Stroke, 2007, 38(2 Suppl): 724-730.
［20］Barkovich AJ, Westmark KD, Bedi HS, Partridge JC, Ferriero DM, Vigneron DB. Proton spectroscopy and diffusion imaging on the first day of life after perinatal asphyxia: preliminary report［J］. AJNR Am J Neuroradiol, 2001, 22(9): 1786-1794.
