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].