Table of Contents
Washington University Experience | INFECTION | Bacteria | Meningitis | Meningitis, complications - acute | 10A0 Case 10 History
Case 10 History ---- This patient was born at 37 weeks estimated gestational age by induced vaginal delivery due to decreased fetal movements and abnormal fetal heart rate. He was healthy until 2-3 days prior to admission when he developed an upper respiratory infection. He became fussy and later he was found lethargic with little respiratory effort. A chest x-ray at this time revealed severe bilateral pulmonary opacities consistent with aspiration. Blood cultures drawn in the emergency room grew beta hemolytic Group B streptococcus. LP revealed a total nucleated cell count of 535 with 94% neutrophils. CSF cultures grew beta hemolytic Group B streptococcus. He lost brainstem reflexes. He developed a left frontal lobe lesion suspicious for cerebritis or infarct adjacent to this hypoattenuating lesion that was concerning for empyema. An MRI brain one day later revealed global loss of gray-white differentiation suggestive of generalized ischemia. Given his poor neurological prognosis, his family decided to provide comfort care only.
