Spinal cord dysfunction complicating bacterial meningitis.

Cervical transverse myelopathy developed in an 8-month-old girl during the early stages of Klebsiella pneumoniae meningitis. Spinal cord dysfunction is an uncommon complication of bacterial meningitis and has not been previously described in patients younger than 1 year old. A literature review of patients 2 years old or older with similar complications showed that young children have cervical cord lesions, whereas the majority of adolescents and adults have thoracic or lumbar lesions. In four of five previously reported cases of patients between 2 and 3 years old, a cardiorespiratory arrest probably played a critical role in the pathogenesis of cord dysfunction. The patient described herein, however, did not experience any cardiorespiratory insufficiency, and cord dysfunction was probably the direct result of local vascular changes and cord ischemia. On follow-up assessment, all patients had persistent neurologic deficits, regardless of age.