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Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease

INTRODUCTION: In countries where Haemophilus influenzae type B vaccine is used, Streptococcus pneumoniae is the most common cause of bacterial meningitis in young children and notable cause of morbidity/mortality. The authors present material of magnetic resonance imaging (MRI) of patients with pneu...

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Autores principales: Bekiesińska-Figatowska, Monika, Duczkowska, Agnieszka, Duczkowski, Marek, Brągoszewska, Hanna, Mądzik, Jarosław, Iwanowska, Beata, Romaniuk-Doroszewska, Anna, Antczak-Marach, Dorota
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518104/
https://www.ncbi.nlm.nih.gov/pubmed/33074177
http://dx.doi.org/10.34763/jmotherandchild.2020241.2010.000009
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author Bekiesińska-Figatowska, Monika
Duczkowska, Agnieszka
Duczkowski, Marek
Brągoszewska, Hanna
Mądzik, Jarosław
Iwanowska, Beata
Romaniuk-Doroszewska, Anna
Antczak-Marach, Dorota
author_facet Bekiesińska-Figatowska, Monika
Duczkowska, Agnieszka
Duczkowski, Marek
Brągoszewska, Hanna
Mądzik, Jarosław
Iwanowska, Beata
Romaniuk-Doroszewska, Anna
Antczak-Marach, Dorota
author_sort Bekiesińska-Figatowska, Monika
collection PubMed
description INTRODUCTION: In countries where Haemophilus influenzae type B vaccine is used, Streptococcus pneumoniae is the most common cause of bacterial meningitis in young children and notable cause of morbidity/mortality. The authors present material of magnetic resonance imaging (MRI) of patients with pneumococcal meningitis from archive of Department of Diagnostic Imaging of Institute of Mother and Child in Warsaw. MATERIALS AND METHODS: We performed 27 brain MRI scans and 1 follow-up computed tomography (CT) in 10 children (2 girls and 8 boys) aged from neonate to 5 years at disease onset with proven pneumococcal infection. RESULTS: Follow-up period range was 0–12 years. Two children underwent only one MRI, one of them died before follow-up and the other was lost from further observation. There was one case of relatively benign disease course with mild changes on MRI. In another seemingly benign case, acute transient hydrocephalus was observed. Six children developed hydrocephalus, and two required ventriculoperitoneal shunting complicated by neuroinfection, shunt malfunction and revisions. Two patients developed epilepsy. In six children, spastic paresis of various severity was diagnosed, up to quadriplegia in one who is under the longest observation (>12 years) and survived in vegetative state. Three other children suffer from delayed psychomotor development to severe intellectual disability. CONCLUSIONS: MRI shows perfectly the degree of central nervous system (CNS) damage during and after pneumococcal invasion. Despite appropriate treatment, disease course may be unpredictably serious. Attempts to eliminate the obligation to vaccinate are extremely irresponsible taking into account potential danger of death, vegetative state or another form of severe damage to CNS. Social and financial costs of care of survivors are very high with shunts placements and changes, (neuro)infections, rehabilitation, families breakdown, etc.
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spelling pubmed-85181042021-11-23 Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease Bekiesińska-Figatowska, Monika Duczkowska, Agnieszka Duczkowski, Marek Brągoszewska, Hanna Mądzik, Jarosław Iwanowska, Beata Romaniuk-Doroszewska, Anna Antczak-Marach, Dorota J Mother Child Original Research Paper INTRODUCTION: In countries where Haemophilus influenzae type B vaccine is used, Streptococcus pneumoniae is the most common cause of bacterial meningitis in young children and notable cause of morbidity/mortality. The authors present material of magnetic resonance imaging (MRI) of patients with pneumococcal meningitis from archive of Department of Diagnostic Imaging of Institute of Mother and Child in Warsaw. MATERIALS AND METHODS: We performed 27 brain MRI scans and 1 follow-up computed tomography (CT) in 10 children (2 girls and 8 boys) aged from neonate to 5 years at disease onset with proven pneumococcal infection. RESULTS: Follow-up period range was 0–12 years. Two children underwent only one MRI, one of them died before follow-up and the other was lost from further observation. There was one case of relatively benign disease course with mild changes on MRI. In another seemingly benign case, acute transient hydrocephalus was observed. Six children developed hydrocephalus, and two required ventriculoperitoneal shunting complicated by neuroinfection, shunt malfunction and revisions. Two patients developed epilepsy. In six children, spastic paresis of various severity was diagnosed, up to quadriplegia in one who is under the longest observation (>12 years) and survived in vegetative state. Three other children suffer from delayed psychomotor development to severe intellectual disability. CONCLUSIONS: MRI shows perfectly the degree of central nervous system (CNS) damage during and after pneumococcal invasion. Despite appropriate treatment, disease course may be unpredictably serious. Attempts to eliminate the obligation to vaccinate are extremely irresponsible taking into account potential danger of death, vegetative state or another form of severe damage to CNS. Social and financial costs of care of survivors are very high with shunts placements and changes, (neuro)infections, rehabilitation, families breakdown, etc. Sciendo 2020-07-29 /pmc/articles/PMC8518104/ /pubmed/33074177 http://dx.doi.org/10.34763/jmotherandchild.2020241.2010.000009 Text en © 2020 Monika Bekiesińska-Figatowska et al., published by Sciendo https://creativecommons.org/licenses/by/4.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Original Research Paper
Bekiesińska-Figatowska, Monika
Duczkowska, Agnieszka
Duczkowski, Marek
Brągoszewska, Hanna
Mądzik, Jarosław
Iwanowska, Beata
Romaniuk-Doroszewska, Anna
Antczak-Marach, Dorota
Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease
title Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease
title_full Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease
title_fullStr Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease
title_full_unstemmed Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease
title_short Pneumococcal Meningitis and its Sequelae – A Devastating CNS Disease
title_sort pneumococcal meningitis and its sequelae – a devastating cns disease
topic Original Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518104/
https://www.ncbi.nlm.nih.gov/pubmed/33074177
http://dx.doi.org/10.34763/jmotherandchild.2020241.2010.000009
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