Fatal Cerebral Vasospasm following a Haemophilus influenzae Meningitis in a Young Child with Ventriculoperitoneal Shunt

Tomoko Tanaka; Heather L Young; Farnaz Norozian; Abdallah Dalabih; Charles M Glasier; Gregory W Albert

doi:10.1159/000512864

Fatal Cerebral Vasospasm following a Haemophilus influenzae Meningitis in a Young Child with Ventriculoperitoneal Shunt

Pediatr Neurosurg. 2021;56(1):90-93. doi: 10.1159/000512864. Epub 2021 Jan 28.

Authors

Tomoko Tanaka¹, Heather L Young², Farnaz Norozian^{3

4}, Abdallah Dalabih⁵, Charles M Glasier⁶, Gregory W Albert⁷

Affiliations

¹ Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA, ttanaka@uams.edu.
² Division of Pediatric Infectious Disease, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
³ Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
⁴ Department of Pediatric Emergecy Medicine, Children's Hospital of Nevada at University Medical Center, Las Vegas, Nevada, USA.
⁵ Division of Pediatric Intensive Critical Care, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
⁶ Division of Pediatric Neuroradiology, Department of Radiology, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
⁷ Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.

PMID: 33508836
DOI: 10.1159/000512864

Abstract

Introduction: Despite the successful implementation of Haemophilus influenzae vaccination, invasive serotypes still lead to a fatal infection. We recently cared for a patient with a ventriculoperitoneal shunt (VPS) and H. influenzae meningitis and septicemia complicated by vasospasm. Vasospasm caused by Haemophilus central nervous system infection has not been previously reported.

Case presentation: A 34-month-old patient with a recent VPS presented with H. influenzae meningitis and sepsis. Despite the explant of hardware, followed by maximum medical management, the patient developed stroke due to severe vasospasm, which led to diffused anoxic brain injury.

Conclusions: We aim to alert for the possible critical condition caused by H. influenzae. It is essential to treat the underlying illness, despite the presence of a VPS. Surgical implant tends to be overlooked by other subspecialists. Being vaccinated to H. influenzae does not protect from different subtypes like non-typeable H. influenzae. The cause of vasospasm remains unclear.

Keywords: Case report; Haemophilus influenzae; Meningitis; Vasospasm; Ventriculoperitoneal shunt.

Publication types

Case Reports

MeSH terms

Child
Child, Preschool
Haemophilus influenzae
Humans
Infant
Meningitis, Haemophilus*
Sepsis*
Vasospasm, Intracranial* / etiology
Ventriculoperitoneal Shunt / adverse effects