Persistent meningeal enhancement on MRI in an infant with culture-negative bacterial meningitis: a case report and systematic review of the literature (2014–2025) - Scorecard - MDSpire
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Persistent meningeal enhancement on MRI in an infant with culture-negative bacterial meningitis: a case report and systematic review of the literature (2014–2025)
Clinical Scorecard: Sustained Meningeal Enhancement Observed on MRI in a Young Infant with Culture-Negative Bacterial Meningitis: A Case Study and Comprehensive Literature Review (2014–2025)
At a Glance
Category
Detail
Condition
Culture-Negative Bacterial Meningitis
Key Mechanisms
Persistent meningeal enhancement due to delayed post-inflammatory repair and residual local inflammation.
Target Population
Infants with bacterial meningitis, particularly those with culture-negative results.
Care Setting
Pediatric emergency and inpatient care.
Key Highlights
Case of a 70-day-old infant with 5-month persistent meningeal enhancement post-CNBM.
Clinical symptoms and CSF parameters normalized after treatment.
MRI findings may mislead clinicians to suspect infection recurrence.
Long-term follow-up is essential for confirming benign prognosis of imaging findings.
Integrated assessment of clinical, laboratory, and imaging data is crucial.
Guideline-Based Recommendations
Diagnosis
Utilize CSF cytology, biochemistry, and microbiology as the gold standard for diagnosis.
MRI has high specificity for diagnosing bacterial meningitis.
Management
Administer standardized antimicrobial therapy based on clinical guidelines.
Monitoring & Follow-up
Conduct long-term serial follow-up to assess for persistent meningeal enhancement.
Risks
Avoid overtreatment based solely on isolated MRI abnormalities.
Patient & Prescribing Data
Infants diagnosed with culture-negative bacterial meningitis.
Meropenem plus vancomycin administered for an 18-day course.
Clinical Best Practices
Integrate clinical symptoms, laboratory parameters, and imaging findings for diagnosis.
Educate clinicians on the implications of persistent meningeal enhancement.
