Cranial Ultrasonography in Evaluation of Meningitis in Neonates and Infants

Abstract

Introduction: Cranial ultrasonography plays an important role in the initial evaluation of infants with suspected meningitis and in evaluation of complications of the disease. Meningitis is a serious infection and commonly affects newborns, infants and children with grave consequences. There are many recent advances in diagnosis and treatment of meningitis. However, still there is residual neurological disability and morbidity. Study aimed to establish role of ultrasonography in evaluation of meningitis & its complication in neonates & infants. Material and methods: 26 Patients with suspected case of meningitis with clinical findings of meningitis and/ or laboratory findings were performed cranial ultrasonography (Logiq P9 GE &Logiq P5 GE) with linear probe (7 to 11 MHz) and Curvilinear probe (3 to 5 MHz). Results: A study was performed on 26 patients (newborn to one year old) of suspected meningitis. Sonograms were obtained within 72 hours of birth, and repeated on 7th, 14th or at an early date, if required. 5 patients were normal on sonography. The spectrum of sonographic abnormalities includes echogenic sulci (53.8%) and parenchyma (30.7%), ventriculomegaly (46%), ventriculitis (23%), cerebral infarction (3.8%), subdural fluid collection/ Subdural empyema (7.6%), extradural fluid collection (3.8%), encephalomalacia (3.8%) and cerebral abscess (7.6%) in patients. Conclusion: Cranial ultrasonography continues as an excellent first line imaging investigation in suspected meningitis cases of infants for initial diagnosis, complications and monitoring the course of the disease. It is a reliable modality and provides useful information for diagnosis and treatment of meningitis and its complications.