Spread of infection to Virchow-Robin spaces in a patient with Streptococcus pneumoniae meningitis.

We present a case of a child with acute bacterial leptomeningeal infection caused by Streptococcus pneumoniae. There was an extension of infection along multiple Virchow-Robin spaces into the brain parenchyma, resulting in multiple microabscesses. These abscesses showed restricted diffusion on the diffusion-weighted images on the initial magnetic resonance imaging. A follow-up magnetic resonance imaging showed evolution of these microabscesses with contrast enhancement that ultimately resolved with antibiotics.