Pneumococcal Meningitis, Cerebral Venous Thrombosis, and Cervical Arterial Dissection

Panício, Maurício Isaac; Foresto, Renato Demarchi; Mateus, Lucas; Monzillo, Paulo Hélio; Alves, Monique Bueno; Silva, Gisele Sampaio

doi:10.1177/1941874412459332

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…CSVT has also been reported with meningitis caused by group B streptococcus, Mycobacterium tuberculosis, Neisseria meningitidis, Fusobacterium necrophorum, and Listeria monocytogenes in children and Streptococcus pneumoniae, Aspergillus, alpha-hemolytic Streptococcus, Borrelia burgdorferi, Proteus vulgaris, and in adults [12][13][14][15][16][17][18][19][20][21]. To our knowledge, CSVT has not been reported in the literature for NTHi.…”

Section: Discussionmentioning

confidence: 79%

Nontypeable Haemophilus influenzae Otitis Media: Mastoiditis and Meningitis Complicated with Central Venous Thrombosis in an Immunocompetent Child

Gönüllü

Özkan

Soysal

et al. 2021

Case Reports in Infectious Diseases

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Implementation of the Haemophilus influenzae type B (Hib) conjugate vaccine brought about a reduction in the number of cases and morbidity from type B but an increase in nontypeable strain infections. Nontypeable Haemophilus influenzae (NTHi) commonly colonizes children’s upper respiratory tract and causes otitis media, sinusitis, and bronchitis. Invasive NTHi diseases, such as meningitis and septicemia, have rarely been reported. Herein, we discuss a previously healthy, fully immunized 3-year-old girl presented with otitis media and mastoiditis leading to meningitis caused by NTHi complicated with central venous thrombosis. She was treated with antibiotics, mastoidectomy and ventilation tube insertion, and anticoagulation therapy and recovered uneventfully. Through this case, we wish to share our unique clinical experience that NTHi should be born in mind as a potential pathogen that can cause meningitis in previously healthy children, which may be helpful in future cases.

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Section: Discussionmentioning

confidence: 79%

Nontypeable Haemophilus influenzae Otitis Media: Mastoiditis and Meningitis Complicated with Central Venous Thrombosis in an Immunocompetent Child

Gönüllü

Özkan

Soysal

et al. 2021

Case Reports in Infectious Diseases

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“…Direct vascular invasion by the bacteria leading to intraparenchymal edema and intravascular coagulation due to the release of procoagulant and antifibrinolytic agents is also a possible mechanism. [ 5 6 ] Systemic infection can also trigger an underlying prothrombotic illness in susceptible individuals. [ 7 ] The other possible hypothesis includes severe cerebral vessel vasospasm owing to catecholamine excess, inflammation of the vessel wall.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and outcome of patients with cerebral venous thrombosis secondary to bacterial infections

Jacob¹,

Gunasekaran²,

Miraclin³

et al. 2020

Ann Indian Acad Neurol

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Background: Cerebral venous thrombosis (CVT) secondary to infectious aetiology has become rare in the antibiotic era, but is still encountered in clinical practice occasionally. In this study, we describe the clinical profile, diagnosis, and management of patients with CVT secondary to an infectious aetiology. Methods: This retrospective study included all adult patients over 15 years (1 January 2002 to 1 January 2017). Adult patients with a diagnosis of infective CVT secondary to bacterial infections were included in the study. Results: Totally, 22 patients were identified with CVT complicating bacterial infections. The focus of infection in 12 (54.54%) patients was pyogenic meningitis, 9 (40.9%) patients had a parameningeal focus and one patient developed CVT secondary to bacterial sepsis from a remote focus. Fever was the most common symptom seen in 77.3% followed by headache and depressed sensorium in 72.7% and 63.6%, respectively. The most common organism in the meningitis group was Streptococcus species, and in the parameningeal group was Staphylococcus aureus . At presentation MRI identified CVT in all 7 patients as compared to CT brain with contrast in 2/3 (66.6%). Transverse sinus was the most commonly involved sinus in meningitis. All patients were treated with appropriate antibiotics and anticoagulation was used in 50% of the patients. The in hospital, mortaility was 9%. Conclusion: Septic CVT, though rare can be a complication of bacterial meningitis and facial infections. Clinical symptoms that suggest a co-existing CVT should be identified and diagnosed at the earliest. The mainstay of treatment is antibiotics; the role of anticoagulation is controversial.

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“…In a model of ischemic stroke, bacterial aspiration led to severe pneumonia, which persisted for fourteen days after stroke induction, suggesting that stroke increases the susceptibility to infection ( 157 ). Another severe vascular complication in pneumococcal meningitis is venous thrombosis ( 158 , 159 ), associated with impairments of blood flow and perfusion pressure, intracranial hemorrhage, BBB dysfunction and cerebral edema ( 160 , 161 ).…”

Section: Brain Injury Following Pneumococcal Invasionmentioning

confidence: 99%

Role of neural barriers in the pathogenesis and outcome of Streptococcus pneumoniae meningitis

Prager

Friedman

Nebenzahl

2017

Experimental and Therapeutic Medicine

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Bacterial meningitis is an inflammatory disease of the meninges of the central nervous system (CNS). Streptococcus pneumoniae (S. pneumoniae), Neisseria meningitidis, and Haemophilus influenzae are the major bacterial pathogens causing meningitis with S. pneumoniae being responsible for two thirds of meningitis cases in the developed world. To reach the CNS following nasopharyngeal colonization and bacteraemia, the bacteria traverse from the circulation across the blood brain barrier (BBB) and choroid plexus. While the BBB has a protective role in healthy individuals by shielding the CNS from neurotoxic substances circulating in the blood and maintaining the homeostasis within the brain environment, dysfunction of the BBB is associated with the pathophysiology of numerous neurologic disorders, including bacterial meningitis. Inflammatory processes, including release of a broad range of cytokines and free radicals, further increase vascular permeability and contribute to the excessive neural damage observed. Injury to the cerebral microvasculature and loss of blood flow auto-regulation promote increased intracranial pressure and may lead to vascular occlusion. Other common complications commonly associated with meningitis include abnormal neuronal hyper-excitability (e.g., seizures) and loss of hearing. Despite the existence of antibiotic treatment and adjuvant therapy, the relatively high mortality rate and the severe outcomes among survivors of pneumococcal meningitis in developing and developed countries increase the urgency in the requirement of discovering novel biomarkers for the early diagnosis as well as novel treatment approaches. The present review aimed to explore the changes in the brain vascular barriers, which allow S. pneumoniae to invade the CNS, and describe the resultant brain injuries following bacterial meningitis.

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Pneumococcal Meningitis, Cerebral Venous Thrombosis, and Cervical Arterial Dissection

Cited by 6 publications

References 13 publications

Nontypeable Haemophilus influenzae Otitis Media: Mastoiditis and Meningitis Complicated with Central Venous Thrombosis in an Immunocompetent Child

Nontypeable Haemophilus influenzae Otitis Media: Mastoiditis and Meningitis Complicated with Central Venous Thrombosis in an Immunocompetent Child

Clinical profile and outcome of patients with cerebral venous thrombosis secondary to bacterial infections

Role of neural barriers in the pathogenesis and outcome of Streptococcus pneumoniae meningitis

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