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Group B Streptococcus Meningitis
Case Detail
| Anatomy: Brain-Spine |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Infectious-Inflammatory |
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| Created: about 1 year ago |
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| Updated: about 1 year ago |
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| Tags:
PEDS
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| Modality/Study Types:
US
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Activities:  PDF  ImageJA |
History
Fullterm newborn with myelomeningocele.
Case Images
Diagnosis
Group B Streptococcus Meningitis
Clinical Notes
Mother colonized with group B streptococcus.
Findings
US – Multifocal hyperechoic lesions, effaced sulci, marked hyperemia on color Doppler and elevated anterior cerebral artery diastolic flow. The dilated and dysmorphic ventricles may be related to meningitis and/or underlying Chiari malformation.
Discussion
The pathophysiology of meningitis is complex. The choroid plexus is most often seeded during sepsis with eventual development of arachnoiditis, ventriculitis, vasculitis and/or thrombophlebitis. Inflammatory mediators (cytokines) and bacterial toxins accentuate the inflammatory process, alter vasogenic stability, disrupt the blood-brain barrier and cause to edema. US findings in meningitis include: pia-arachnoid thickening (>1.3 mm over convexity or >2 mm in a sulcus), reactive hygroma, subdural empyema, thickened and irregular ependyma, intraventricular debris, intraventricular adhesions, hydrocephalus, focal or diffuse infarcts (venous or arterial), parenchymal edema, abscess, pia-arachnoid hyperemia, increased diastolic flow (loss of autoregulation) and decreased diastolic flow (increased intracranial pressure and edema).
Reference
Yikilmaz A, Taylor GA. Sonographic findings in bacterial meningitis in neonates and young infants. Pediatr Radiol (2008); 38:129-137.