Late Diagnosis of Escherichia coli Meningitis in a 6-year-old Febrile Male Child: A Case Report
DOI:
https://doi.org/10.60787/tnhj.v23i1.639Keywords:
Escherichia coli, meningitis, 6-year-old, late diagnosisAbstract
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 5th 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.
Downloads
References
Ahmed H. Inflammatory Diseases of the Central Nervous System. In: Paediatrics and Child Health in a Tropical Region. 3rded. Azubuike JC, Nkangineime KEO, editors.Lagos: EducationalPrinting and Publishing; 2016; 1183-98.
KandilM, Khalil G, El-Attar E, Shehata G, Hassan S. Accuracy of heparin binding protein: As a new marker in prediction of acute bacterial meningitis.Braz. J. Microbiol2018,49(Suppl. S1):213–219.
Kohlmann R, Nefedev A, Kaase M, Gatermann SG. Community-acquired adult Escherichiacoli meningitis leading to diagnosis of unrecognized retropharyngeal abscess and cervical spondylodiscitis: a case report. BMC Infect Dis2015; 15:567. doi: 10.1186/s12879-015-1310-4.
Ouchenir L, Renaud C, Khan S, Bitnum A, Boisvert AA, McDonald J et al. The Epidemiology, Management and Outcomes of Bacterial Meningitis in infants. Paediatrics2017; 140:e20170476
Okike IO,Johnson AP,Henderson KL Blackburn RM, Muller-Pebody M, Ladhani SN etal.Incidence, aetiologyand outcome of bacterial meningitis in infants aged <90 days in the UK and Republic of Ireland: prospective, enhanced, national population-based surveillance.Clin Infect Dis2014;59:e150–7
Shrestha RG, Tandukar S, Ansari S, Subedi A, Shrestha A, Poudel R et al. Bacterial meningitis in children under 15 years of age in Nepal.BMC Pediatrics2015; 15:94.https://doi.org/10.1186/s12887-015-0416-6
Ahmed M, Ejaz M, Jahangeer A, Khan S, Riaz Hashmi S S, Jawaid T et al. Frequency and Associated Factors of Parental Refusal to Perform Lumbar Puncture in Children with Suspected Central Nervous System Infection: A Cross-sectional Study.Cureus2019; 11(9): e5653. https://doi.org/10.7759/cureus.5653
Elafros MA, Belessioitis-Richards C, Birbeck GL, Bond V, Sikazwe I, Kvalsund MP.Lumbar puncture-related knowledge, attitudes, and practices among patients, caregivers, doctors, and nurses in Zambia.Am J Trop Med Hyg2021;104(5):1925–31.
Basmaci R, Bonacorsi S, Bidet P, Biran V, Aujard Y, Bingen E et al. Escherichia Coli Meningitis Features in 325 Children From 2001 to 2013 in France.Clin Infect Dis2015;61(5):779–786. doi:10.1093/cid/civ367.
Mado SM, Aliyu I. Acute bacterial meningitis in nigerian children beyond neonatal period: A review. Niger J Basic Clin Sci2018; 15:1-4.
Mado SN,Aikhionbare HO, Akpede GO. Pattern and antimicrobial sensitivity of pathogens in acute bacteria meningitis beyond neonatal period at Ahmadu Bello University Teaching Hospital (ABUTH) Shika and Zaria. Niger J Paed2013;40 (1):70 -74
Mueller M, Tainter CR. Escherichia coli. In:StatPearls(Internet). Treasure Island (FL): Stat Pearls Publishing; 2021. Available at https://www.ncbi.nlm.nih.gov/books/NBK564298/. Assessed on 17thFebruary, 2023
Ku LC, Boggess KA, Cohen-Wolkowiez M. Bacterial meningitis in infants.Clin Perinatol2015;42(1):29-viii. doi:10.1016/j.clp.2014.10.004
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Journal and Publisher
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.