An unusual case of meningococcal meningitis complicated with subdural empyema in a 3 month old infant: a case reportReport as inadecuate




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Cases Journal

, 2:6335

First Online: 17 September 2009Received: 30 May 2009Accepted: 12 June 2009DOI: 10.4076-1757-1626-2-6335

Cite this article as: Yip, K., Gosling, R.D., Jones, V. et al. Cases Journal 2009 2: 6335. doi:10.4076-1757-1626-2-6335

Abstract

Subdural empyema is an unusual complication of meningococcal meningitis, and in acute cases can be rapidly fatal. We present a case of an 8 week old infant who presented with atypical Neisseria meningitis with bifrontal subdural empyema formation. Through the utilisation of modern polymerise chain reaction tests on cerebrospinal fluid samples, we were able to confirm the diagnosis and institute appropriate treatment. Early surgical intervention and appropriate intravenous antibiotics meant that the patient fully recovered. In summary, early treatment of meningitis without adequate microbiological investigations can complicate later diagnosis of subdural empyema. Early suspicion of empyema should be considered when patient fails to improve after 48 hrs, seizures are a late sign and gives a poorer prognosis. Computed tomography scanning is still the modality of choice although in this case, magnetic resonance imaging had its benefits. Polymerase chain reaction of cerebrospinal fluid testing may also provide an important confirmatory test in future.

AbbreviationsCRPC- reactive protein

CSFcerebrospinal fluid

CTcomputed tomography

EU-IBISEuropean Invasive Bacterial Infections Surveillance Network

MRImagnetic resonance imaging

PCRpolymerase chain reaction

TTEtransthoracic echocardiogram.

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Author: Kawai Yip - Roly D Gosling - Victoria Jones - Ian K Hosein

Source: https://link.springer.com/







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