Enterococcal Central Nervous System Infections in Children: A 22 Years' Experience in a Tertiary Center and Review of the Literature.


Journal

The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858

Informations de publication

Date de publication:
26 Mar 2024
Historique:
medline: 27 3 2024
pubmed: 27 3 2024
entrez: 27 3 2024
Statut: aheadofprint

Résumé

Enterococcal meningitis in children is rare, and its clinical presentation, laboratory characteristics and outcomes are not well defined. We conducted a retrospective analysis of Enterococcal meningitis cases during 2002-2023 at our tertiary center. We identified 10 cases in children aged 2 weeks to 15 years (median age: 8 months). Seven children were males and 9 had comorbidities, including a ventriculoperitoneal shunt in 5 children. All children with shunt infections presented with nonspecific signs and symptoms. While 8 children presented with fever, only 3 had signs of meningeal irritation and altered consciousness. Cerebrospinal fluid pleocytosis was evident in almost all children with a median of 173 cells/mL. Nine cases were due to Enterococcus faecalis, and 1 case was due to E. faecium. All 5 children with ventriculoperitoneal shunt underwent shunt removal and replacement. All children recovered without documented sequelae. Enterococcal meningitis is rare, especially in healthy neonates. It typically occurs following neurosurgical interventions and may only present with fever and shunt malfunction, without overt meningeal signs and with mild inflammation. The prognosis is favorable.

Sections du résumé

BACKGROUND BACKGROUND
Enterococcal meningitis in children is rare, and its clinical presentation, laboratory characteristics and outcomes are not well defined.
METHODS METHODS
We conducted a retrospective analysis of Enterococcal meningitis cases during 2002-2023 at our tertiary center.
RESULTS RESULTS
We identified 10 cases in children aged 2 weeks to 15 years (median age: 8 months). Seven children were males and 9 had comorbidities, including a ventriculoperitoneal shunt in 5 children. All children with shunt infections presented with nonspecific signs and symptoms. While 8 children presented with fever, only 3 had signs of meningeal irritation and altered consciousness. Cerebrospinal fluid pleocytosis was evident in almost all children with a median of 173 cells/mL. Nine cases were due to Enterococcus faecalis, and 1 case was due to E. faecium. All 5 children with ventriculoperitoneal shunt underwent shunt removal and replacement. All children recovered without documented sequelae.
CONCLUSIONS CONCLUSIONS
Enterococcal meningitis is rare, especially in healthy neonates. It typically occurs following neurosurgical interventions and may only present with fever and shunt malfunction, without overt meningeal signs and with mild inflammation. The prognosis is favorable.

Identifiants

pubmed: 38535091
doi: 10.1097/INF.0000000000004342
pii: 00006454-990000000-00809
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to disclose.

Références

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Auteurs

Aviad Schnapp (A)

From the Department of Pediatrics, Faculty of Medicine, Hebrew University of Jerusalem.
Pediatric Division, Department of Pediatrics, Hadassah Medical Center Jerusalem.

Sergei Elber-Dorozko (S)

From the Department of Pediatrics, Faculty of Medicine, Hebrew University of Jerusalem.
Pediatric Division, Department of Pediatrics, Hadassah Medical Center Jerusalem.

Violeta Temper (V)

Department of Clinical Microbiology, Clinical Microbiology Laboratory.

Oren Gordon (O)

From the Department of Pediatrics, Faculty of Medicine, Hebrew University of Jerusalem.
Pediatric Division, Department of Pediatrics, Hadassah Medical Center Jerusalem.
Department of Clinical Microbiology, Pediatric Infectious Diseases Unit, Hadassah Medical Center, Jerusalem, Israel.

Dina Averbuch (D)

From the Department of Pediatrics, Faculty of Medicine, Hebrew University of Jerusalem.
Pediatric Division, Department of Pediatrics, Hadassah Medical Center Jerusalem.
Department of Clinical Microbiology, Pediatric Infectious Diseases Unit, Hadassah Medical Center, Jerusalem, Israel.

Classifications MeSH