Abstract
Recurrent bacterial meningitis is a life-threatening infection of the central nervous system that is mostly connected with anatomical abnormalities of the skull, chronic parameningeal infections and immunodeficiencies. It’s rarely seen, but when it occurs an extensive investigation should be carried out to discover the responsible factor, so that further episodes can be prevented. We report on a child with split hand and foot (SHFM), confirmed incorrect karyotype 46, XY, t(7:12)(q21.2;q21.3) and a fourth episode of fulminant meningitis caused by penicillin-resistant Streptococcus pneumoniae. After a broad evaluation of factors predisposing to recurrent meningitis, the undiagnosed malformation of his inner and middle ears - Mondini dysplasia was found. We suggest examining all children with SHFM for hearing impairment before they develop recurrent meningitis. The time when the radiological procedure for searching for inner ear dysplasia should be performed could be a controversial issue: before or after the first episode of meningitis. From the epidemiological point of view, high-resolution computer tomography scanning of the temporal bones should be considered after the diagnosis of deafness in a child with SHFM related to 7q21 deletion.
Highlights
Bacterial meningitis is a severe, life-threatening infection of the central nervous system (CNS) that is associated with high rates of significant disability and morbidity in children
We report on a 13-year-old boy with split hand and foot malformations (SHFM) who suffered from recurrent Streptococcus pneumoniae meningitis due to undiagnosed Mondini dysplasia of his ears
Two months after the 4th episode the child had the left subtotal petrosectomy performed to protect him against recurrent bacterial meningitis
Summary
Bacterial meningitis is a severe, life-threatening infection of the central nervous system (CNS) that is associated with high rates of significant disability and morbidity in children. The predisposing factors for recurrent bacterial meningitis can be categorized into congenital and acquired and both groups can be divided into anatomical abnormalities, chronic parameningeal infections and immunodeficiencies such as asplenia, human immunodeficiency virus infection and complement system deficiency (Janocha-Litwin and Simon 2013). Different cranial and spinal anatomic defects can facilitate the migration of bacteria to cerebrospinal fluid (CSF). Another frequent abnormality is congenital inner ear malformations with communication between the subarachnoid space and the air-filled cells or paranasal sinuses, which is the leading cause of recurrent bacterial meningitis (Yang et al 2008). In patients with congenital defects of different organs and recurrent meningitis, evaluation of inner ear malformation should be the first diagnostic step in the protection against further episodes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Developmental and Physical Disabilities
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
