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Neuropediatrics 2011; 42(06): 240-244
DOI: 10.1055/s-0031-1295407
Short Communication
© Georg Thieme Verlag KG Stuttgart · New York

Complicated Pneumococcal Meningitis in a Fully Vaccinated Child: Value of Magnetic Resonance Imaging Monitoring

S. Ilia
1   Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
,
A.-M. Spanaki
1   Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
,
M. Raissaki
2   Department of Radiology, University Hospital of Heraklion, Heraklion, Crete, Greece
,
V. I. Spoulou
3   1st Department of Pediatrics, Division of Infectious Diseases ‘Aghia Sophia’ Children’s Hospital, Athens University School of Medicine, Athens, Greece
,
M.-D. Fitrolaki
1   Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
,
M. Kanariou
4   Department of Immunology – Histocompatibility, “Aghia Sophia” Children’s Hospital, Athens, Greece
,
G. Tzanakaki
5   National Meningitis Reference Laboratory, National School of Public Health, Athens, Greece
,
G. Briassoulis
1   Pediatric Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
› Author Affiliations
Further Information

Publication History

received 28 July 2011

accepted 25 October 2011

Publication Date:
14 November 2011 (online)

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Abstract

We present a unique case of life-threatening pneumococcal meningitis complicated by vasculitis in a fully vaccinated 4-year-old female with the heptavalent conjugate vaccine for Streptococcus pneumoniae (PCV7). Serotype 23F was isolated in both blood and cerebral spinal fluid (CSF) samples. Pulses of methylprednisolone were promptly initiated in addition to antibiotics leading to a good recovery. CSF studies and magnetic resonance imaging (MRI) of the brain were used for diagnosis and monitoring the response to corticoid therapy. We report the investigations of a child with failure of PCV7 vaccine to protect against vaccine-serotype invasive disease. Use of corticosteroids and temporal association with changes in brain imaging are described for the first time in literature.

Key words

meningitis - magnetic resonance imaging - pulse of steroids - vasculitis - Streptococcus pneumonia - PCV7
 

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