“ Life-threatening illness due to infection of the subarachnoid space. In neonates, the most common source of infection is the mother’s urog...
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Life-threatening illness due to infection of the subarachnoid space. In neonates, the most common source of infection is the mother’s urogenital tract; causative pathogens are therefore group B Streptococcus, Gram-negative rods, etc. After the neonatal period, the most common pathogens are Streptococcus pneumoniae (most common between 1 and 23 months of age).
US
• Look for evidence of ventriculitis (up to 90% affected; e.g. hydrocephalus, echogenic debris/septations in the ventricles, thickened ependymal surface)
• Subdural effusion case by Haemophilus influenzae (common) or empyema (rare)
• Consider post-contrast imaging.
• Hydrocephalus, subdural effusion or empyema and intracerebral abscess.
• Check for sinusitis.
• Most useful for diagnosis and detection of complications
• CSF spaces not as low signal on T1 as usual—CSF spaces may be effaced due to oedema
• Enhancement of the leptomeninges—seen on T1 post-contrast or fluid attenuated inversion recovery (FLAIR) post-contrast (non-specific)
• Subdural empyema—collection in the subdural space high signal on both T1 and T2
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