Brain imaging can predict neurodevelopmental outcome of Group B streptococcal meningitis in neonates

<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>The association between cranial ultrasound (<jats:styled-content style="fixed-case">CUS</jats:styled-content>) or magnetic resonance imaging (<jats:styled-content style="fixed-case">MRI</jats:styled-content>) lesions and neonatal Group B streptococcal (<jats:styled-content style="fixed-case">GBS</jats:styled-content>) meningitis outcome has not been studied in detail.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This retrospective study assessed <jats:styled-content style="fixed-case">CUS</jats:styled-content>, cranial <jats:styled-content style="fixed-case">MRI</jats:styled-content> and neurodevelopmental outcome in 50 neonates with <jats:styled-content style="fixed-case">GBS</jats:styled-content> meningitis admitted to three neonatal intensive care units in the Netherlands between 1992 and 2014. Death, cognitive outcome and motor outcome below −1 <jats:styled-content style="fixed-case">SD</jats:styled-content> were considered as adverse outcomes.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>CUS was available in all and <jats:styled-content style="fixed-case">MRI</jats:styled-content>s in 31 infants (62%) with 28 <jats:styled-content style="fixed-case">CUS</jats:styled-content> (56%) and 27 <jats:styled-content style="fixed-case">MRI</jats:styled-content>s (87%) being abnormal. <jats:styled-content style="fixed-case">MRI</jats:styled-content> lesions were multifocal (n = 10, 37%), bilateral (n = 22; 82%) and extensive (n = 11; 41%). A total of 10 died in the neonatal period. Median age at assessment was 24 months. Among survivors, abnormal cognitive outcome and motor outcome were seen in 23 and 20 patients, respectively. Abnormal <jats:styled-content style="fixed-case">CUS</jats:styled-content> [odds ratio (<jats:styled-content style="fixed-case">OR</jats:styled-content>) 5.3, p = 0.017], extensive bilateral deep grey lesions (<jats:styled-content style="fixed-case">OR</jats:styled-content> 6.7, p = 0.035) and white matter lesions (<jats:styled-content style="fixed-case">OR</jats:styled-content> 14.0, p = 0.039) correlated with abnormal motor outcome. Extensive bilateral deep grey matter lesions correlated with abnormal cognitive outcome (<jats:styled-content style="fixed-case">OR</jats:styled-content> 8.1, p = 0.029).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Abnormal <jats:styled-content style="fixed-case">CUS</jats:styled-content> and the most severely affected <jats:styled-content style="fixed-case">MRI</jats:styled-content>s were associated with poor neurodevelopmental outcome in neonatal <jats:styled-content style="fixed-case">GBS</jats:styled-content> meningitis.</jats:p></jats:sec>