Neuropediatrics 2000; 31(2): 97-99
DOI: 10.1055/s-2000-7474
Short Communication

Georg Thieme Verlag Stuttgart · New York

Cerebellar Involvement as a Rare Complication of Pneumococcal Meningitis

G. Drost1 , A. Verrips2 , M. H.O. Thijssen3 , M. F.J. Gabreëls2
  • Departments of 1 Neurology, 2 Paediatric Neurology and 3 Radiology, University Hospital Nijmegen, The Netherlands
Further Information

Publication History

Publication Date:
31 December 2000 (online)

A 4-year old girl with meningitis, caused by streptococcus pneumoniae, developed a subcoma with respiratory insufficiency, followed by a severe cerebellar syndrome. Cerebellar involvement after regaining consciousness consisted of a symmetrical ataxia and mutism. This mutism changed into dysarthria and finally into normal speech. Magnetic resonance imaging revealed lesions in both cerebellar hemispheres, suggesting cerebellitis. She recovered with prompt antibiotic treatment.

References

  • 1 Adeloye A, Oyedeji G A. Surgical aspects of nontuberculous bacterial meningitis in infancy and childhood. The successful use of conservative surgery in management of some of its complications.  Clin Pediatr Phila. 1973;  12 589-593
  • 2 Bodino J, Lylyk P, Del Valle M, Wasserman J P, Leiguarda R, Monges J. et al . Computed tomography in purulent meningitis.  Am J Dis Child. 1982;  136 495-501
  • 3 Dastur D K, Manghani D K, Udani P M. Pathology and pathogenetic mechanisms in neurotuberculosis.  Radiol Clin North Am. 1995;  33 733-752
  • 4 Davis C W, McIntyre P B. Invasive pneumococcal infection in children, 1981 - 1992: a hospital-based study.  J Paediatr Child Health. 1995;  31 317-322
  • 5 Delmas M C, Gauthier C, Rapin F. [Neurological manifestations of mycoplasma pneumoniae infections] Manifestations neurologiques des infections a Mycoplasma pneumoniae.  Arch Pediatr. 1996;  3 573-575
  • 6 Dodge P R, Davis H, Feigin R D, Holmes S J, Kaplan S L, Jubelirer D P. et al . Prospective evaluation of hearing impairment as a sequela of acute bacterial meningitis.  N Engl J Med. 1984;  311 869-874
  • 7 Domingo Z, Peter J C. Intracranial tuberculomas. An assessment of a therapeutic 4-drug trial in 35 children.  Pediatr Neurosci. 1989;  15 161-166
  • 8 Farmer T W, Wise G R. Subdural empyema in infants, children and adults.  Neurology. 1973;  23 254-261
  • 9 Feske S K, Carrazana E J, Kupsky W J, Volpe J J. Uncal herniation secondary to bacterial meningitis in a newborn.  Pediatr Neurol. 1992;  8 142-144
  • 10 Fraiture de D M, Sie T H, Boezeman E H, Haanen H C. Cerebellitis as an uncommon complication of infectious mononucleosis.  Neth J Med. 1997;  51 79-82
  • 11 Grigoriadis E, Gold W L. Pyogenic brain abscess caused by Streptococcus pneumoniae: case report and review.  Clin Infect Dis. 1997;  25 1108-1112
  • 12 Grimwood K, Nolan T M, Bond L, Anderson V A, Catroppa C, Keir E H. Risk factors for adverse outcomes of bacterial meningitis.  J Paediatr Child Health. 1996;  32 457-462
  • 13 Hanna L S, Girgis N I, Abu el Ella A H, Farid Z. Ocular complications in meningitis: “fifteen years study”.  Metab Pediatr Syst Ophthalmol. 1988;  11 160-162
  • 14 Horowitz M B, Pang D, Hirsch W. Acute cerebellitis: case report and review.  Pediatr Neurosurg. 1991;  17 142-145
  • 15 Kirkpatrick B, Reeves D S, MacGowan A P. A review of the clinical presentation, laboratory features, antimicrobial therapy and outcome of 77 episodes of pneumococcal meningitis occurring in children and adults.  J Infect. 1994;  29 171-182
  • 16 Kline M W, Kaplan S L. Computed tomography in bacterial meningitis of childhood.  Pediatr Infect Dis J. 1988;  7 855-857
  • 17 Pikis A, Kavaliotis J, Tsikoulas J, Andrianopoulos P, Venzon D, Manios S. Long-term sequelae of pneumococcal meningitis in children.  Clin Pediatr Phila. 1996;  35 72-78
  • 18 Sawaishi Y, Takahashi I, Hirayama Y, Abe T, Mizutani M, Hirai K. et al . Acute cerebellitis caused by Coxiella burnetii.  Ann Neurol. 1999;  45 124-127
  • 19 Schmahmann J D, Sherman J C. The cerebellar cognitive affective syndrome.  Brain. 1988;  121 561-579
  • 20 Tolly T L, Wells R G, Sty J R. MR features of fleeting CNS lesions associated with Epstein-Barr virus infection.  J Comput Assist Tomogr. 1989;  13 665-668
  • 21 Van der Meyden C H, De Villiers J F, Middlecote B D, Terblanche J. Gadolinium ring enhancement and mass effect in acute disseminated encephalomyelitis.  Neuroradiology. 1994;  36 221-223
  • 22 Van Dongen H R, Catsman Berrevoets C E, Van Mourik M. The syndrome of “cerebellar” mutism and subsequent dysarthria.  Neurology. 1994;  44 2040-2046

M. D. Gea Drost

Department of Neurology University Hospital Nijmegen P. O. Box 9101

6500 HB Nijmegen

The Netherlands

    >