Neonatal Meningococcal Meningitis Complicated by Cerebral Sinovenous Thrombosis

Background/Objective: Neisseria meningitidis is one of the major causes of meningitis in children and adolescents, but it is rarely found during the neonatal period. The outcome of meningococcal disease can be fatal and depends on the innate immune system, age, serogroups, pre-existing antibodies, and other unknown host factors. We report a case of an eight day old with serogroup B meningococcal meningitis complicated by cerebral sinovenous thrombosis (CSVT).

Method: Clinical data, laboratory and radiological records of our case were reviewed.

Results: An eight day old male neonate presented with fever, poor feeding and subtle seizures. Neisseria meningitidis serogroup B was isolated in blood and cerebrospinal fluid by viral polymerase chain reaction. Magnetic resonance venography (MRV) of the brain demonstrated sagittal sinus thrombosis. He was managed on twelve week course of daily subcutaneous tinzaprin (low molecular weight heparin). Follow up MRVs confirmed re-canalization of the vessel after anticoagulant therapy. He made a remarkable recovery and was followed up till one year of age with no neurological sequale.

Conclusion: To the best of our knowledge, this is the first documented case of neonatal meningococcal meningitis complicated by CSVT in Republic of Ireland. It is a rare but fatal complication which can be managed if detected early.

Keywords: neonatal meningitis, cerebral venous thrombosis, serogroup B, tinzaparin