A child recovering from culture-proven bacterial meningitis develops recurrent fever and persistent vomiting in the second week. CT head reveals a crescentic extra-axial fluid collection over the convexity without significant mass effect. Which organism was most likely responsible for the original infection?

• A Escherichia coli
• B Haemophilus influenzae type b ✓
• C Group B Streptococcus
• D Neisseria meningitidis

Explanation

Subdural effusion complicating bacterial meningitis is classically associated with Haemophilus influenzae type b meningitis in infants and young children. Most effusions are sterile transudates that resolve spontaneously, and drainage is reserved for large collections with raised intracranial pressure or proven empyema. Meningococcal disease is linked instead to petechial rash and Waterhouse-Friderichsen syndrome, while coliform and Group A Streptococcus infections occur in neonates where subdural collections are uncommon.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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