Late Diagnosis of Escherichia coli Meningitis in a 6-year-old Febrile Male Child: A Case Report

Late Diagnosis of Escherichia coli Meningitis in a 6-year-old Febrile Male Child

Abstract

Background: Meningitis in children is often life-threatening and a major cause of morbidity and mortality. The diagnosis is often given away by convulsions, and sometimes other neurological signs in a febrile child. Earlier requests for cerebrospinal fluid analysis can help lessen the morbidity and avert long hospital stays and death among children in the resource-poor setting.

Methods: The study was carried out using the case note of a patient managed in the children ward of a tertiary health centre in Umuahia, South-East, Nigeria

Results: A six-year-old male child whose initial history of short-lived convulsion was withheld by the mother, a health worker.  Cerebrospinal fluid (CSF) analysis which was eventually done on the 5^th day of admission revealed an Escherichia Coli (E. Coli) infection which is not common in the child’s age group. It was then treated successfully with antibiotics based on the antimicrobial susceptibility, and the child has been free of any neurologic deficits for the last 3 years.

Conclusion: Need for a higher index of suspicion even in febrile school-aged children who appear not to have obvious neurological signs and symptoms has been brought to the fore. Hence, for children with less obvious or unreported initial convulsions or neurologic symptoms, a thorough history and physical examination, followed by CSF analysis is needed. Since Escherichia coli is an uncommon aetiologic agent for meningitis in this child’s age group, further studies will be needed to elucidate the aetio-pathogenic factors.