Mukherjee Devdeep, Saha Agnisekhar
Department of Pediatric Medicine, Institute of Child Health Kolkata, India.
Department of Pediatric Medicine, Fortis Hospitals, Anandapur, Kolkata, India.
Iran J Child Neurol. 2017 Fall;11(4):81-84.
Cerebral vasculitis is a serious complication of meningitis with We report a 5 yr old girl who was admitted in May 2015 at Fortis Hospital, Kolkata, India and was diagnosed to have pneumococcal meningitis with vasculitis on DWMRI within a week of onset of fever. She was given high dose of methyl-prednisolone simultaneously with antibiotics and successfully treated without any neuro-sequelae. Although vasculitis has been documented to develop as sequelae to bacterial meningitis usually in the second week, our patient had an early presentation. Treatment with high dose steroid along with antibiotics resulted in dramatic improvement with no neurodeficit. DW-MRI is an important investigation to pick up early, evidence of vasculitis in a patient with meningitis who is showing neurological deteriorations despite improvement in blood parameters.
脑血管炎是脑膜炎的一种严重并发症。我们报告一名5岁女孩,于2015年5月入住印度加尔各答的富通医院,发热一周内经DWMRI诊断为肺炎球菌性脑膜炎合并血管炎。她在使用抗生素的同时接受了大剂量甲基强的松龙治疗,成功治愈且无任何神经后遗症。虽然血管炎通常在细菌性脑膜炎发病第二周作为后遗症出现,但我们的患者发病较早。大剂量类固醇联合抗生素治疗使病情显著改善,无神经功能缺损。对于脑膜炎患者,尽管血液指标有所改善但仍出现神经功能恶化,DW-MRI是早期发现血管炎证据的重要检查手段。