Summary

This report describes a 2-month-old girl who developed a subdural empyema as a rare complication of meningococcal disease. The initial presentation was compatible with bacterial meningitis and sepsis and remarkable only for a lymphocytic pleocytosis of the cerebrospinal fluid (CSF), which was confirmed at a later occasion. After a week, when the patient continued to have fever, and subsequently developed focal seizure activity, MRI brain revealed a subdural empyema, necessitating craniectomy with a washout. Initial CSF and blood cultures were negative, but PCR analysis of the CSF from the primary lumbar puncture was positive for Neisseria meningitidis. She responded well to 6 weeks of intravenous meropenem and CT scan of the brain at the end of the treatment was normal. At 4-month follow-up, she was seizure-free with normal neurological examination and development.