Bacterial meningitis

Case contributed by Raihanah Haroon
Diagnosis almost certain

Presentation

Presented with altered behavior, fever and slurred speech. Positive family history of SLE. WCC 6.9. Lumbar puncture: high CSF protein and opening pressure, WBC 1332

Patient Data

Age: 30 years
Gender: Female
ct

Findings: 

Case Discussion

Meningitis is defined as infection of the pia matter, arachnoid and adjacent CSF.

It can be divided into pachymeningitis (infection of dura matter) or leptomeningitis (infection of pia matter, arachnoid and CSF).

Patients often present with headache, stiff neck, confusion, disorientation with positive CSF analysis.

The role of imaging is to exclude parenchymal abscess, ventriculitis, localized empyema; evaluate PNS/ temporal bone as a source of infection and to monitor complications.

Complications include cerebritis, ventriculitis, brain atrophy, brain infarction, subdural effusion, hydrocephalus & cranial nerve dysfunction.

Hydrocephalus in meningitis is caused by cellular debris blocking the foramen of Monro, aqueduct, 4th ventricular outlet, or caused by intraventricular septa/ arachnoid adhesion.

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