Presentation
Fever, headache, and altered sensorium.
Patient Data
A trace amount of slightly hyperdense content in the occipital horns of the bilateral lateral ventricles.
The fluid-fluid level in the posterior horn of the bilateral lateral ventricles shows diffusion restriction on DWI with the corresponding hypointense signal on the ADC map.
Minimal diffuse pachymeningeal enhancement along the bilateral cerebral convexity.
The CSF report is suggestive of bacterial etiology.
Case Discussion
The complete blood count of the patient was marked neutrophilic leukocytosis.
So overall CBC, CSF analysis, and imaging findings are highly suggestive of pyogenic meningitis with ventriculitis due to streptococcus pneumoniae.
Co-author: Dr. Sanaullah Mudassir (DM, Neuro-medicine).
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