Open AccessSilent Mastoiditis Associated with Pneumococcal Meningitis
Author(s) -
Ashikin Mohd Nordin,
Jean Jun Ong,
Juriza Ismail,
Norazlin Kamal Nor,
Sau Wei Wong,
Noor Dina Hashim,
Fahrin Zara Mohammad Nasseri,
Adibah Abdul Ghafar,
Erica Yee Hing,
Nudiyasrudin,
Asma Abdullah
Publication year - 2021
Publication title -
malaysian journal of paediatrics and child health
Language(s) - English
Resource type - Journals
ISSN - 1511-4511
DOI - 10.51407/mjpch.v27i2.118
Subject(s) - meningitis , mastoiditis , medicine , streptococcus pneumoniae , otitis , pediatrics , surgery , antibiotics , microbiology and biotechnology , biology
Streptococcus pneumoniae (S pneumoniae) can cause a wide spectrum of diseases which includes upper respiratory tract infection as well as more severe invasive disease such as meningitis. Meningitis may be caused by invasion of the organism through the blood brain barrier, either via haematological spread or from an adjacent focus of infection such as the ears. We describe two infants with pneumococcal meningitis and silent mastoiditis. They both presented with a classical history to suggest meningitis with no apparent focus of infection. A brain imaging was done in the first infant to look for the underlying cause of his focal seizure and in the second infant, to assess for complications of meningitis, as he had a slow recovery. While they did not have any clinical signs to point towards the diagnosis, they were both diagnosed to have acute mastoiditis from brain imaging. We would like to highlight the importance of brain imaging in excluding silent mastoiditis in infants with meningitis, particularly in those whose clinical course appears atypical.