Bacillus cereus Meningoencephalitis in Preterm Infants: Neuroimaging Characteristics
Maarten H. Lequina,
Jeroen R. Vermeulenc,
Ruurd M. van Elburgd,
Frederik Barkhofe,
René F. Kornelisseb,e,
Renate Swarteb and
Paul P. Govaertb
a Department of Radiology, Sophia Children’s Hospital, Erasmus MC—University Medical Center, Rotterdam, the Netherlands
b Department of Pediatrics, Division of Neonatology , Sophia Children’s Hospital, Erasmus MC—University Medical Center, Rotterdam, the Netherlands
c Department of Pediatric Neurology , VU University Medical Center Amsterdam, the Netherlands
d Department of Neonatology , VU University Medical Center Amsterdam, the Netherlands
e Department of Radiology , VU University Medical Center Amsterdam, the Netherlands
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FIG 1. Case 3. A, Coronal sonography (8.5 MHz) on day 15 with hyperechogenicity of subcortical white matter with a shift of the midline and the beginning of necrosis of the left hemisphere. B, Coronal sonography on day 23 showing thickening of ependyma and septae due to ventriculitis.
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FIG 2. Case 1. MR on day 7 has characteristics of hemorrhage in the white matter on (A) sagittal T1-weighted (TR 780 ms; TE 14 ms) and (B) axial T2-weighted (TR 3000 ms; TE 120 ms) images. C, Axial FLAIR (TR 9000 ms; TE 105 ms) image shows the extensive hemorrhagic meningoencephalitis. D, DWI (EPI sequence TE 128 ms; b = 1000 mm2/s) also showed restricted diffusion at the thalamus and cortex at the perisylvian and calcarine area and cerebellum.
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FIG 3. Case 2. T1-weighted (A) (TR 780 ms; TE 14 ms) with hyperintensities right parietal and left frontal and T2-weighted (B) (TR 3000 ms; TE 120 ms) images, showing diffuse hypointensities at the level of the centrum semiovale, right frontal and left occipital and some hyperintensity right periventricular occipitally. On DWI (C) images (EPI sequence TE 128 ms; b = 1000 mm2/s), hyperintensity is seen on the left parietal, insular area, calcarine cortex, and thalamus at the left side and at the level of the mesencephalon.
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FIG 4. Case 3. On day 15 axial T1-weighted SE (A), axial T2 TSE (B), and coronal FLAIR (C) images show hemorrhagic liquefactive necrosis of the left hemisphere (case 3). D, Diffusion-weighted image (TR, 1440 ms; TE, 146 ms; b = 756 mm2/s) shows restrictive diffusion in the calcarine area.
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