Open AccessRefractory status epilepticus due to pneumococcal meningitis in an infant with congenital immunodeficiency
Author(s) -
Prasanth Sudhakaran,
Velayudhan Cheruvallil Shaji,
Lyla Chacko,
Jayalakshmi Vasudevapanicker
Publication year - 2016
Publication title -
journal of pediatric neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.247
H-Index - 18
eISSN - 1998-3948
pISSN - 1817-1745
DOI - 10.4103/1817-1745.187636
Subject(s) - medicine , meningitis , status epilepticus , streptococcus pneumoniae , refractory (planetary science) , immunodeficiency , antibiotics , pediatrics , immunology , epilepsy , microbiology and biotechnology , psychiatry , physics , immune system , astrobiology , biology
Pneumococcal meningitis remains a life-threatening infection, with varied presentations. A 3 month-old-baby with pneumococcal meningitis presented with clusters of seizures evolving into refractory status epilepticus despite standard antibiotic and aggressive anticonvulsant therapy. Progressive illness despite antibiotic initially suggested possible antibiotic resistance and resulted in addition of another antibiotic. Nonresponse to standard treatment and previous history of abscess in the back of neck pointed to some underlying congenital immunodeficiency. Further evaluation showed a deficiency of complement factor C3. This case underlines the need to consider underlying immunodeficiency in cases of refractory status epilepticus due to bacterial meningitis. Gram-staining of cerebrospinal fluid sample showing plenty of Gram-positive bacteria and comparatively fewer pus cells is a clue regarding some underlying immunodeficiency.