Background. Although the clinical features of bacterial meningitis in healthy patients have been described, very limited literature is available describing clinical features of meningitis in cerebral palsy patients. We performed a retrospective review of bacterial meningitis in cerebral palsy patients to determine its clinical presentation, microbiology and outcome.

Method. We reviewed the medical records of all patients younger than 18 years old with documented cerebral palsy and bacterial meningitis at DACH in Jaipur, Rajasthan, from January, 1998, to December, 2017.

Results. During the study period there were eighteen cases of bacterial meningitis in seventeen cerebral palsy patients. None of them had recent neurosurgery, a central nervous system device or cerebrospinal fluid leak. Neutropenia was present in 82% of patients. Fever was the most consistent signs at presentation. In addition at least one additional symptom or sign of meningitis (headache, neck pain or rigidity, seizures or photophobia) was present in only 16.7% of cases. Staphylococcus aureus was the most common microbiologic isolate. The three patients with fatal outcome were neutropenic. Fever and seizures within 5 days of presentation were associated with long term neurologic sequelae.

Conclusions. Meningitis in cerebral palsy patients was associated with significant morbidity. Clinical features of meningitis in cerebral palsy patients were distinctly different from those of normal children with meningitis. Diagnosis of bacterial meningitis is more difficult in cerebral palsy patients.