Annals of Indian Academy of Neurology
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MRI spectrum of haemophilus influenzae meningoencephalitis in childrenmri spectrum of haemophilus influenzae meningoencephalitis in children


1 Department of Radiodiagnosis and Imaging, Post graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
2 Department of Pediatrics, Post graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
3 Department of Medicine, Government Medical College and Hospital (GMCH), Chandigarh, India
4 Department of Immunopathology, Post graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
5 Departments of Radiodiagnosis and Imaging, Post graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
6 Departments of Senior Consultant and Associate Professor Child Neurology, Neuropediatric Unit, Astrid Lindgren's Children's Hospital, Karolinska, Stockholm, Sweden
7 Department of Pediatrics, Medanta, The Medicity, Gurugram, NCR, Haryana; Former: Department of Pediatrics PGIMER, Chandigarh, India

Correspondence Address:
Pratibha Singhi,
Director Pediatric Neurology and Neurodevelopment, Medanta, The Medicity, Gurgaon - 122 001, Haryana

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.AIAN_500_19

Background and Purpose: Haemophilus influenzae type b (Hib) infection occurs mostly in children and is transmitted from person to person through the respiratory pathway. Hib strain is associated with meningitis or encephalitis. It is not an uncommon infection, particularly, in the developing world. This prospective cohort study was done with the aim of describing imaging findings in patients with Hib meningoencephalitis. Materials and Methods: In a prospective cohort study, consecutive children admitted in the pediatric emergency unit with acute febrile encephalopathy were enrolled. The clinical details, CSF analysis, and microbiological and serological investigations were recorded on a case record proforma. Children with confirmed Hib meningoencephalitis were included in this study. Clinicoradiological features were assessed. Results: A total of 16 patients with acute febrile encephalopathy, in whom CSF latex agglutination, CSF culture, or CSF multiplex PCR were positive for H. influenzae were included in this study. All these children were investigated with magnetic resonance imaging (MRI) brain. Important imaging findings were meningitis, predominantly around frontoparietal lobes (43%), cerebritis (28%), ventriculitis (14%), and subdural collections (21.5%). One patient had features consistent with acute disseminated encephalomyelitis (ADEM) while four patients had normal MRI scan. Conclusions: H. influenzae is still a common cause of meningitis in infants and children in the developing world. We have tried to study the most common MRI features associated with Hib infection to help radiologists alert the treating clinicians to further investigate these patients for appropriate prognostication.


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