C-reactive protein as an indicator of aqueductal gliosis and hydrocephaly in neonatal meningitis

Serial C-reactive protein (CRP) measurements appear to be helpful in following clinical course and response to treatment of serious bacterial infections in neonates, such as meningitis, septicaemia and osteomyelitis. In previous studies, serial determination of serum CRP could detect potential complications of meningitis, such as subdural effusion, purulent arthritis and osteomyelitis, and secondary skin infection. We report an 11-day-old full-term male neonate with persistent positive CRP after treatment of bacterial meningitis, and who developed hydrocephaly at follow-up. We concluded that positive CRP was secondary to aqueduct gliosis; therefore monitoring of serum CRP levels in infants with bacterial meningitis represented useful information, not only in persistent or secondary infection, but also for destructive complications of meningitis.