Recurring E. coli meningitis in an infant

Abstract

Despite advances in diagnostic approach, antibiotic therapy and intensive care, bacterial meningitis is still associated with a significant mortality and a high number of complications and neurological sequelae. Although the vast majority are single episodes, approximately 1-4.8% of all cases of acute bacterial meningitis are recurrent, which is defined as the reappearance of signs and symptoms of meningitis by the same microorganism or a new episode by a different microorganism that occurs at least 3 weeks after the sterilization of the cerebrospinal fluid (CSF). Different factors predisposing to recurrent meningitis have been identified, such as deficits in humoral and cellular immunity and congenital or acquired structural defects that establish an anatomical communication between the subarachnoid space and the skin or the middle ear and the paranasal cavities. The clinical history and the findings of the physical examination and the microbiological data can help guide the origin of meningitis. A prompt identification of immunological deficiencies or anatomical defects is important in preventing new episodes and potential sequelae.