Brain magnetic resonance imaging of infants with bacterial meningitis

Carlos R. Oliveira, Michael C. Morriss, John G. Mistrot, Joseph B. Cantey, Christopher D. Doern, Pablo J. Sánchez

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives To describe the results of brain magnetic resonance imaging (MRI) of infants with bacterial meningitis and how the findings affected clinical management. Study design This retrospective study included all infants <12 months of age who were hospitalized at Children's Medical Center, Dallas and had culture-confirmed bacterial meningitis and a brain MRI from January 1, 2001 to December 1, 2011. Infants were identified by review of all positive bacterial cultures of cerebrospinal fluid (CSF) from the Children's Medical Center Microbiology Laboratory. Demographic, clinical, laboratory, and neuroimaging data were reviewed. Infants with ventriculoperitoneal shunt or whose CSF culture yielded skin commensals were excluded. A neuroradiologist blinded to clinical information reviewed all MRI studies. Results Of the 440 infants who had a positive CSF culture result, 111 (25%) had a pathogen isolated from CSF and were enrolled in the study. Of these, 68% (75/111) had a brain MRI performed during the hospitalization; abnormalities included leptomeningeal enhancement (57%), cerebral infarct (43%), subdural empyema (52%), cerebritis (26%), hydrocephalus (20%), and abscess (11%). By multiple logistic regression analysis, infants with late seizures and an abnormal neurologic examination were more likely to have an abnormal MRI (P <.05). MRI results led to neurosurgical intervention in 23% of infants; a positive bacterial culture of CSF obtained >48 hours after initiation of antibiotic therapy was associated with neurosurgical intervention (P =.01). Fourteen (19%) infants with bacterial meningitis had a normal brain MRI. Conclusions Brain MRIs were performed frequently and often were abnormal in infants with bacterial meningitis, leading to changes in clinical management.

Original languageEnglish (US)
Pages (from-to)134-139
Number of pages6
JournalJournal of Pediatrics
Volume165
Issue number1
DOIs
StatePublished - 2014

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Bacterial Meningitides
Magnetic Resonance Imaging
Brain
Retrospective Studies
Anti-Bacterial Agents
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Oliveira, C. R., Morriss, M. C., Mistrot, J. G., Cantey, J. B., Doern, C. D., & Sánchez, P. J. (2014). Brain magnetic resonance imaging of infants with bacterial meningitis. Journal of Pediatrics, 165(1), 134-139. https://doi.org/10.1016/j.jpeds.2014.02.061

Brain magnetic resonance imaging of infants with bacterial meningitis. / Oliveira, Carlos R.; Morriss, Michael C.; Mistrot, John G.; Cantey, Joseph B.; Doern, Christopher D.; Sánchez, Pablo J.

In: Journal of Pediatrics, Vol. 165, No. 1, 2014, p. 134-139.

Research output: Contribution to journalArticle

Oliveira, CR, Morriss, MC, Mistrot, JG, Cantey, JB, Doern, CD & Sánchez, PJ 2014, 'Brain magnetic resonance imaging of infants with bacterial meningitis', Journal of Pediatrics, vol. 165, no. 1, pp. 134-139. https://doi.org/10.1016/j.jpeds.2014.02.061
Oliveira, Carlos R. ; Morriss, Michael C. ; Mistrot, John G. ; Cantey, Joseph B. ; Doern, Christopher D. ; Sánchez, Pablo J. / Brain magnetic resonance imaging of infants with bacterial meningitis. In: Journal of Pediatrics. 2014 ; Vol. 165, No. 1. pp. 134-139.
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