MKP infection - keywords
the sequence of events in neonatal bacterial brain infection
microbial agent enters into the brain
haematogenous
via foreign body (shunt)
from adjacent infection
(skull, neurenteric cyst …)
in parenchyma
in choroid plexus
ependymitis/ventriculitis and
subjacent phlebitis
abscess
formation
in leptomeninges
liquefaction
necrosis
in haemorrhage occuring
during bacteraemia
subdural purulent collection
with leptomeningeal reaction
pial arteritis and
phlebitis
empyema of the
cavum septi pellucidi
erratic destruction of
(sub)cortical areas
obstruction of liquor flow due
to adhesions in the ventricles
or the subarachnoid space
large pial
artery stroke
perforator arteritis
and stroke
early onset group B streptococcus meningitis: multiple arterial striatal perforator strokes
GBS meningitis presenting with seizures on day 6 after term birth
day 9
day 6
day 8
evolution from fuzzy hyperechoic areas into circumscript infarcts in putamen and caudate head
early onset group B streptococcus meningitis: ischaemic perforator strokes with haemorrhagic conversion
term infant, presenting on day 3 with GBS meningitis and seizures
day 3
day 4
late onset group B streptococcus meningitis: leptomeningitis with subcortical infarction
preterm infant with late onset GBS meningitis, prolonged antibiotherapy
(sub)acute images: extensive subdural collections, arachnoiditis and meningeal thickening
term infant with late onset GBS meningitis
day of admission: hyperechoic collections in and around the frontoparietal cortex
increase of echogenicity in both thalami
CUS at term shows resolution of the subdural
collections
ventricular dilatation stabilized spontaneously
afterwards
diffusion MRI one day after initial CUS scan
Escherichia Coli meningitis and ventriculitis
preterm infant (GA 26w) with initial IVH grade 2, subsequent E. Coli
ventriculitis around day 5: evolving intraventricular changes
preterm infant (GA 30w) with initial IVH grade 3, subsequent E. Coli
ventriculitis around day 14 with abscess formation over the cerebellar surface
R mastoid CUS
faintly hyperechoic
conglomerates
hydrocephalus sparing
fourth ventricle
abscess
cerebellar
hemisphere
vermis
transventricular
strands
adhesions and
compartmentalisation
L mastoid CUS
preterm
Magendi
term
pericerebellar
debris
term
cerebellar
hemisphere
cisterna magna
enterobacterial meningitis/encephalitis
preterm with enterobacter septicaemia, fasciotomy for necrosis of a
foot, thrombocytopenia
ELBW with pseudomonas septicaemia and extensive microabscedation
of the entire brain preceding total dissolution prior to demise
irregular
vermis
margins
intracerebellar
destruction and
membrane formation
triventricular
hydrocephalus with
Rickham reservoir
26 wk preterm, day 15: Serratia marcescens sepsis and meningitis
5 days later
citrobacter encephalitis in a term infant
bacillus cereus meningo-encephalitis
preterm 30w, sepsis screen 48 h ago; lethargic, normal CSF and full fontanelle
preterm 33w PMA with bacillus cereus in blood and CSF
predominantly unilateral frontal white matter destruction
predominantly unilateral extensive white matter destruction
listeria encephalitis
MCA stroke complicating listeria septicaemia in a term infant
bilateral hyperechoic white matter change with radial character
courtesy LS de Vries, Utrecht
staphylococcus aureus abscess
parietal cerebral abscess with
stafylococcus aureus
cerebellar abscess with stafylococcus aureus
(two different preterm infants)
candida encephalitis
preterm infant: acute stage
macro-abscess formation one week later
abscess
aspergillus abscess formation
day 20
HELLP syndrome, caesarean at GA 27w, birthweight 600 g,
skin infection at peripheral deep line on day 13, aspergillus
in blood and CSF day 14; MR result of 6w intravenous
liposomal amphotericin B followed by voriconazole
day 35
courtesy dr More-Jaroslavceva, Riga
enterovirus encephalitis/meningitis
late preterm, seizures caused by enterovirus meningitis at 2 1/2 weeks
acute stage DW MRI
after 1 month: cystic evolution
rotavirus encephalitis/meningitis
late preterm, seizures caused by rotavirus infection at 2 weeks
acute stage DW MRI
after 1 month: cystic evolution