Brain magnetic resonance imaging findings suggestive of widespread white matter involvement in children with Streptococcus mitis meningitis.

Streptococcus mitis (S. mitis) is a rare cause of meningitis in immunocompetent children. It has been described in patients with neurosurgical procedure, previous spinal anesthesia and immunodeficiency. We report two childhood cases of S. mitis meningitis. The children were previously healthy. One of the patients had poor oral hygiene and the other had a history of sinusitis. Both of them had encephalopathy and signs of meningeal irritation at presentation. Widespread cerebral white matter lesions were found on brain magnetic resonance imaging. The lesions disappeared and encephalopathy recovered with antibiotic and immunomodulatory treatment.