Introduction:
Bartter syndrome is a rare genetic disorder that impairs the kidneys’ ability to reabsorb electrolytes, causing a spectrum of clinical manifestations including hypokalemia, metabolic alkalosis, and normotensive or hypotensive blood pressure [1]. These symptoms result from defects in the function of certain kidney transport channels or carriers, leading to electrolyte imbalances that can complicate both the diagnosis and management of affected individuals [1]. In infants, particularly premature ones, physiological immaturity, and reduced renal function may intensify these challenges and complicate the clinical picture [2].
While Bartter syndrome has been extensively studied, the literature on its co-occurrence with severe neurological complications, such as hydrocephalus and ventriculitis, particularly those secondary to meningitis, is scarce [3,4,5]. Hydrocephalus, an abnormal cerebrospinal fluid (CSF) accumulation within the brain’s ventricles, and ventriculitis, inflammation of these ventricles, may occur secondary to meningitis [4,5]. The treatment of these conditions in a premature infant with underlying Bartter syndrome presents an array of clinical challenges given the complex interplay of electrolyte imbalances, renal dysfunction, and neurological complications [2,6]
This report aims to elaborate on a particularly complex clinical scenario involving an infant born prematurely at 32+4 weeks, with a birth weight of 1.7 kg and diagnosed with Bartter syndrome [1,7]. The infant developed hydrocephalus and ventriculitis secondary to unresolved meningitis, further complicating his clinical management [3,4,5]. The objective of this report is to underscore the intricacies involved in managing such a patient and to highlight the multidisciplinary and individualized approaches that were instrumental in ensuring optimal patient outcomes [6,8]. Through this case presentation, we aim to enrich the current body of knowledge on Bartter syndrome and contribute valuable insights on handling its co-occurrence with severe neurological complications [9,10].