MENINGITIS CAUSING IVH IN A TERM NEONATE WITH SEIZURES MASQUERADING STROKE - A CASE REPORT

Abstract

Intraventricular hemorrhage (IVH) occurs in preterm infants; however, the occurrence of this event is less frequent in term neonates. In this present case study our objective is to evaluate clinical, radiological features & outcome of a term neonate with IVH. Materials & Methods: This is a case report of full-term neonate admitted to the Neonatal Intensive Care Unit (NICU) of DR DY PATIL Hospital, PUNE March 2022. IVH was diagnosed using cranial ultrasonography & brain magnetic resonance imaging (MRI). Results:  The age of onset of symptoms was 4 days. Seizure was the commonest clinical symptom. There is no history of poor feeding, lethargy, fever, hypothermia, vomiting, trauma or coma.The source of  bleeding in the brain was parenchyma. Severity of bleeding include grade 4 IVH. Routine lab reports showed no coagulopathy. CSF routine showed bacterial meningitis & blood culture was positive for Streptococcus Parasanguinis. CSF culture had no growth. Treatment: Baby was kept on NBM & empirically treated with iv antibiotics. Conclusion: The main source of IVH in term neonate is choroid plexus; the most common clinical symptom include focal seizure, and IVH event is of grade 4. Novelty of this case is meningitis presenting as grade 4 IVH in a term neonate with hypoxic ischemic hypoglycemic injury with normal perinatal history. The neonate is discharged from NICU without any CNS complication.