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Comparison of CSF and MRI Findings among Neonates and Infants with E coli or Group B Streptococcal Meningitis.
AJNR Am J Neuroradiol 2019; 40(8):1413-1417AA

Abstract

BACKGROUND AND PURPOSE

Group B Streptococcus and Escherichia coli (E coli) are the 2 most common causes of bacterial meningitis in neonates. The purpose of this study was to determine whether CSF and/or MR imaging findings differ between infants with group B streptococcal or E coli meningitis.

MATERIALS AND METHODS

A retrospective review was performed among neonates (younger than 28 days) and infants (younger than 120 days) with proved group B streptococcal (n = 57) or E coli meningitis (n = 50). A CSF or blood culture positive for Streptococcus or E coli and an elevated CSF white blood cell count were used as the criterion standard. Independent, blinded review of brain MRIs obtained within 21 days of presentation were performed by 2 board-certified neuroradiologists. CSF laboratory values and MR imaging findings were compared between the groups.

RESULTS

There was no statistically significant difference between the mean age at presentation for patients with group B streptococcal (40 days; range, 2-111 days) versus patients with E coli meningitis (31 days; range, 12-115 days) (P = .18). There was no statistically significant difference in the CSF white blood cell count, glucose, or protein. There was a significant difference between group B streptococcal and E coli meningitis in the frequency of hydrocephalus (0% versus 22%, P = .001) and infarct (40% versus 14%; P = .038), respectively. There was no statistically significant difference in leptomeningeal enhancement, cerebritis, ventriculitis, abscess/granuloma, subdural effusion, extra-axial purulent material, intraventricular purulent material, hemorrhage, and sinus thrombosis.

CONCLUSIONS

Although neonates and infants with group B streptococcal or E coli meningitis had similar age and CSF laboratory values, patients with group B streptococcal meningitis more frequently demonstrated infarcts, while those with E coli meningitis more frequently had early onset of hydrocephalus.

Authors+Show Affiliations

From the Department of Radiology (S.F.K., M.K.K., M.J.P., N.K.D.), Texas Children's Hospital, Houston, Texas steve.kralik@gmail.com. Indiana University Riley Children's Hospital (S.F.K.), Indianapolis, Indiana.From the Department of Radiology (S.F.K., M.K.K., M.J.P., N.K.D.), Texas Children's Hospital, Houston, Texas.From the Department of Radiology (S.F.K., M.K.K., M.J.P., N.K.D.), Texas Children's Hospital, Houston, Texas.From the Department of Radiology (S.F.K., M.K.K., M.J.P., N.K.D.), Texas Children's Hospital, Houston, Texas.Department of Pediatrics (J.G.V.), Baylor College of Medicine, Houston, Texas.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31320464

Citation

Kralik, S F., et al. "Comparison of CSF and MRI Findings Among Neonates and Infants With E Coli or Group B Streptococcal Meningitis." AJNR. American Journal of Neuroradiology, vol. 40, no. 8, 2019, pp. 1413-1417.
Kralik SF, Kukreja MK, Paldino MJ, et al. Comparison of CSF and MRI Findings among Neonates and Infants with E coli or Group B Streptococcal Meningitis. AJNR Am J Neuroradiol. 2019;40(8):1413-1417.
Kralik, S. F., Kukreja, M. K., Paldino, M. J., Desai, N. K., & Vallejo, J. G. (2019). Comparison of CSF and MRI Findings among Neonates and Infants with E coli or Group B Streptococcal Meningitis. AJNR. American Journal of Neuroradiology, 40(8), pp. 1413-1417. doi:10.3174/ajnr.A6134.
Kralik SF, et al. Comparison of CSF and MRI Findings Among Neonates and Infants With E Coli or Group B Streptococcal Meningitis. AJNR Am J Neuroradiol. 2019;40(8):1413-1417. PubMed PMID: 31320464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of CSF and MRI Findings among Neonates and Infants with E coli or Group B Streptococcal Meningitis. AU - Kralik,S F, AU - Kukreja,M K, AU - Paldino,M J, AU - Desai,N K, AU - Vallejo,J G, Y1 - 2019/07/18/ PY - 2019/03/20/received PY - 2019/06/17/accepted PY - 2019/7/20/pubmed PY - 2019/7/20/medline PY - 2019/7/20/entrez SP - 1413 EP - 1417 JF - AJNR. American journal of neuroradiology JO - AJNR Am J Neuroradiol VL - 40 IS - 8 N2 - BACKGROUND AND PURPOSE: Group B Streptococcus and Escherichia coli (E coli) are the 2 most common causes of bacterial meningitis in neonates. The purpose of this study was to determine whether CSF and/or MR imaging findings differ between infants with group B streptococcal or E coli meningitis. MATERIALS AND METHODS: A retrospective review was performed among neonates (younger than 28 days) and infants (younger than 120 days) with proved group B streptococcal (n = 57) or E coli meningitis (n = 50). A CSF or blood culture positive for Streptococcus or E coli and an elevated CSF white blood cell count were used as the criterion standard. Independent, blinded review of brain MRIs obtained within 21 days of presentation were performed by 2 board-certified neuroradiologists. CSF laboratory values and MR imaging findings were compared between the groups. RESULTS: There was no statistically significant difference between the mean age at presentation for patients with group B streptococcal (40 days; range, 2-111 days) versus patients with E coli meningitis (31 days; range, 12-115 days) (P = .18). There was no statistically significant difference in the CSF white blood cell count, glucose, or protein. There was a significant difference between group B streptococcal and E coli meningitis in the frequency of hydrocephalus (0% versus 22%, P = .001) and infarct (40% versus 14%; P = .038), respectively. There was no statistically significant difference in leptomeningeal enhancement, cerebritis, ventriculitis, abscess/granuloma, subdural effusion, extra-axial purulent material, intraventricular purulent material, hemorrhage, and sinus thrombosis. CONCLUSIONS: Although neonates and infants with group B streptococcal or E coli meningitis had similar age and CSF laboratory values, patients with group B streptococcal meningitis more frequently demonstrated infarcts, while those with E coli meningitis more frequently had early onset of hydrocephalus. SN - 1936-959X UR - https://www.unboundmedicine.com/medline/citation/31320464/Comparison_of_CSF_and_MRI_Findings_among_Neonates_and_Infants_with_E_coli_or_Group_B_Streptococcal_Meningitis L2 - http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=31320464 DB - PRIME DP - Unbound Medicine ER -