Clival defect in the pathogenesis of recurrent meningitis: a case report and literature review
Abstract Background Meningitis is a life-threatening infection often associated with high morbidity. Recurrent bacterial meningitis poses a clinical challenge, both clinically and diagnostically. To prevent further recurrences, the underlying causes of recurrent bacterial meningitis should be invest...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2019-11-01
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| Series: | Egyptian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41984-019-0066-3 |
| _version_ | 1818268767480709120 |
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| author | Ahmet Naci Emecen Reyhan Ertekin Begumhan Baysal Ferhat Arslan Haluk Vahaboglu |
| author_facet | Ahmet Naci Emecen Reyhan Ertekin Begumhan Baysal Ferhat Arslan Haluk Vahaboglu |
| author_sort | Ahmet Naci Emecen |
| collection | DOAJ |
| description | Abstract Background Meningitis is a life-threatening infection often associated with high morbidity. Recurrent bacterial meningitis poses a clinical challenge, both clinically and diagnostically. To prevent further recurrences, the underlying causes of recurrent bacterial meningitis should be investigated intensively. Case presentation Here, we aim to present a patient referred to our clinic with rhinorrhea and found to the Staphylococcus aureus meningitis related to a clival defect. The patient reported no history of trauma, surgery, or brain neoplasm, and the cerebrospinal fluid leakage was classified as spontaneous. The patient had two episodes of meningitis in the last 4 years, but etiologic data of the previous episodes were absent. A pneumococcal vaccine was administered following her second attack, suggesting a possible Staphylococcus aureus infection due to altered colonization in the sinuses. She was successfully treated with linezolid but refused surgery to correct the defect and was discharged without neurologic sequelae. Conclusion Spontaneous cerebrospinal fluid leakage from the clivus which could provoke recurrent meningitis is a rare situation. In conjunction with appropriate rapid antibiotherapy for the prevention of recurrent meningitis, the removal of anatomical risk factors should be a principal aim. Effective surgical procedures prevent recurrences. |
| first_indexed | 2024-12-12T20:43:43Z |
| format | Article |
| id | doaj.art-3abe9e8e89fa4e6ab0e5bd55b7462f15 |
| institution | Directory Open Access Journal |
| issn | 2520-8225 |
| language | English |
| last_indexed | 2024-12-12T20:43:43Z |
| publishDate | 2019-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Journal of Neurosurgery |
| spelling | doaj.art-3abe9e8e89fa4e6ab0e5bd55b7462f152022-12-22T00:12:38ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252019-11-013411410.1186/s41984-019-0066-3Clival defect in the pathogenesis of recurrent meningitis: a case report and literature reviewAhmet Naci Emecen0Reyhan Ertekin1Begumhan Baysal2Ferhat Arslan3Haluk Vahaboglu4Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet UniversityDepartment of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet UniversityDepartment of Radiology, Istanbul Medeniyet UniversityDepartment of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet UniversityDepartment of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet UniversityAbstract Background Meningitis is a life-threatening infection often associated with high morbidity. Recurrent bacterial meningitis poses a clinical challenge, both clinically and diagnostically. To prevent further recurrences, the underlying causes of recurrent bacterial meningitis should be investigated intensively. Case presentation Here, we aim to present a patient referred to our clinic with rhinorrhea and found to the Staphylococcus aureus meningitis related to a clival defect. The patient reported no history of trauma, surgery, or brain neoplasm, and the cerebrospinal fluid leakage was classified as spontaneous. The patient had two episodes of meningitis in the last 4 years, but etiologic data of the previous episodes were absent. A pneumococcal vaccine was administered following her second attack, suggesting a possible Staphylococcus aureus infection due to altered colonization in the sinuses. She was successfully treated with linezolid but refused surgery to correct the defect and was discharged without neurologic sequelae. Conclusion Spontaneous cerebrospinal fluid leakage from the clivus which could provoke recurrent meningitis is a rare situation. In conjunction with appropriate rapid antibiotherapy for the prevention of recurrent meningitis, the removal of anatomical risk factors should be a principal aim. Effective surgical procedures prevent recurrences.http://link.springer.com/article/10.1186/s41984-019-0066-3ClivusRhinorrheaStaphylococcus aureusRecurrent meningitisPneumococcal polysaccharide vaccine |
| spellingShingle | Ahmet Naci Emecen Reyhan Ertekin Begumhan Baysal Ferhat Arslan Haluk Vahaboglu Clival defect in the pathogenesis of recurrent meningitis: a case report and literature review Egyptian Journal of Neurosurgery Clivus Rhinorrhea Staphylococcus aureus Recurrent meningitis Pneumococcal polysaccharide vaccine |
| title | Clival defect in the pathogenesis of recurrent meningitis: a case report and literature review |
| title_full | Clival defect in the pathogenesis of recurrent meningitis: a case report and literature review |
| title_fullStr | Clival defect in the pathogenesis of recurrent meningitis: a case report and literature review |
| title_full_unstemmed | Clival defect in the pathogenesis of recurrent meningitis: a case report and literature review |
| title_short | Clival defect in the pathogenesis of recurrent meningitis: a case report and literature review |
| title_sort | clival defect in the pathogenesis of recurrent meningitis a case report and literature review |
| topic | Clivus Rhinorrhea Staphylococcus aureus Recurrent meningitis Pneumococcal polysaccharide vaccine |
| url | http://link.springer.com/article/10.1186/s41984-019-0066-3 |
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