Intraventricular empyema caused by Neisseria meningitidis
| Autor: | Darshan Gandhi, Sonali Gupta, Divyansh Bajaj, David Regelmann, Reba Varughese, Ankit Agrawal |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty 030106 microbiology Infectious and parasitic diseases RC109-216 Neisseria meningitidis medicine.disease_cause Article 03 medical and health sciences Lethargy 0302 clinical medicine Ventriculitis medicine 030212 general & internal medicine medicine.diagnostic_test Lumbar puncture business.industry Meninges medicine.disease Empyema Infectious Diseases medicine.anatomical_structure Intraventricular empyema Chills medicine.symptom business Meningitis |
| Zdroj: | IDCases, Vol 15, Iss, Pp-(2019) IDCases |
| ISSN: | 2214-2509 |
| Popis: | Meningitis is defined as an inflammation of the protective covering of brain and spinal cord collectively called as meninges. Meningeal infection can be complicated by intraventricular empyema. There are 9 cases of intraventricular empyema described in the literature out of which only three are described to be caused by Neisseria meningitidis. We report the fourth rare case.A 61-year-old female with past medical history of diabetes and hypertension presented with the chief complaint of fever with chills and headache of 1-day duration. CT head did not reveal any acute abnormalities. Lumbar puncture was obtained and empiric IV antimicrobial agents were started. CSF analysis showed gram negative diplococci with culture growing Neisseria meningitidis suggesting meningococcal meningitis. Due to persistent headache and lethargy after complicated meningitis was suspected and MRI of brain was obtained which reflected a diagnosis of intraventricular empyema.Pyogenic ventriculitis also known as intraventricular empyema or ependymitis, is a defined as an inflammation of the ependymal lining of the cerebral ventricular system and is characterized by the presence of suppurative fluid in the ventricles. It is a health care associated complication and is often confused with meningitis due to the similar presentation. Therefore, persistent symptoms despite optimal antimicrobial therapy (therapeutic failure) should alarm the presence of pyogenic ventriculitis.This is the fourth case of intraventricular empyema reported secondary to Neisseria meningitidis. Our case reiterates that clinicians should maintain an index of suspicion for complicated meningitis in patients not responding to standard antimicrobial therapy. Keywords: Ventriculitis, Neisseria meningitidis, Intraventricular empyema |
| Databáze: | OpenAIRE |
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