What is the role of MRI in the workup of Haemophilus influenzae type b (Hib) meningitis?

Updated: Jul 09, 2018
  • Author: Prateek Lohia, MD, MHA; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Other important abnormalities that scans may detect tend to develop later in the course of Hib meningitis and constitute complications of the disease. In many cases, these abnormalities are better defined by MRI than by CT scanning. Indications for obtaining such scans, whether CT or MRI, include the following:

  • Persistence of fever after several days of appropriate IV antibiotic therapy (occurs in approximately 10% of all cases of Hib meningitis)

  • Return of fever after achievement of an afebrile state with appropriate IV antibiotic therapy

  • Evidence suggesting increased ICP (eg, bulging fontanelle, Cushing reflex, obtundation, meningismus, cranial nerve signs suggestive of herniation), hydrocephalus, large subdural effusion, or empyema

  • Focal neurologic deficits

  • Prolonged obtundation or coma


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