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Question:

Our little girl of 6 yrs has had confirmed Pneumococcal Meningitis twice now. The first case was January 2008 and the 2nd case July 2009. Previous to this, she had a head injury in April 2007 & had a CSF leak from her nose. CT Scans have shown no possible leaks are still present and show nothing of any concern. After the first case, she was given the Prevenar vaccination and now after the more recent case, she has had 2 more Prevenar Vaccinations, 1 Pneumovax 2 vaccination. We are still awaiting blood test results to see if antibodies are now present in her blood following the vaccinations. We went to see an E.N.T Consultant at Leics Royal Infirmary last week to see if there is still any evidence of a weakening or hole in her meninges following the accident as this could leave her exposed to recurrent meningitis - he did look a short way up her nose with a camera but advised that there was no evidence of a hole, no leak present and that as she is still a child and growing, the hole where the CSF leaked previously would have / should have mended now. He advised that he didnt want to do a 'full' endoscopic investigation because this, itself, could provoke a leak. Is there anything else that we should be asking for to try and prevent further cases for Ellie. We, as parents, still fight this trauma everyday and I still have nightmares that it will come back again. We daredn't take Ellie abroad incase it returns - luckily, we were on holiday in the UK last July when she fell ill again with it. She is on prophylactic Amoxycillin Penicillin until blood tests are returned or until we reach a conclusion but we still feel there is more that could be done to help prevent it returning for a 3rd time. Pls help! Thankyou

Answer:

Dr Andrew Riordan says:

It must be worrying for you that your little girl has had meningitis twice. People who have a CSF leak after a head injury can get recurrent episodes of meningitis. To protect people with CSF leaks from meningitis we usually;

1. Give vaccines against the common germs that cause meningitis. This includes pneumococcal vaccines (prevenar and pneumoxax) plus Hib and Meningitis C vaccines (if levels against these are low).
2. Give preventative antibiotics. This is mostly penicillin or amoxicillin. This gives extra protection, especially against the germs which are not in the vaccines.
3. Find and close CSF leaks. These can be very difficult to find and close.

My usual advice in this situation is to keep taking the preventative amoxicillin until the specialists are sure that the CSF leak has been identified and closed.

Comments

Fiona Burdett
Posts: 1

new comment
Reply #1 on : Thu February 25, 2010, 12:30:31

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Thankyou for your advice. It seems as though the course of action we are taking & the procedures being followed by our hospital & consultants is 'standard' and there is nothing else glaringly apparent that we should be doing. We will, as always, remain extra vigilant with Ellie and any symptoms she shows. We just thank God that the 2nd time she fell ill with this terrible illness, we recognised the signs early enough to aid recovery. My heart goes out to all who have lost someone to this illness and I admire them for their strength to carry on. We struggle with the aftermath on a daily basis.

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