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

By:

Yip, K

Contributor(s):

ISSN:

17571626

Uniform titles:

Cases Journal

Online resources:

Summary: Subdural empyema is an unusual complication ofmeningococcal meningitis, and in acute cases can be rapidly fatal. We present acase of an 8 week old infant who presented with atypical Neisseria meningitis with bifrontalsubdural empyema formation. Through the utilisation of modern polymerise chainreaction tests on cerebrospinal fluid samples, we were able to confirm thediagnosis and institute appropriate treatment. Early surgical intervention andappropriate intravenous antibiotics meant that the patient fully recovered. Insummary, early treatment of meningitis without adequate microbiological investigationscan complicate later diagnosis of subdural empyema. Early suspicion of empyemashould be considered when patient fails to improve after 48 hrs, seizures are alate sign and gives a poorer prognosis. Computed tomography scanning is stillthe modality of choice although in this case, magnetic resonance imaging hadits benefits. Polymerase chain reaction of cerebrospinal fluid testing may alsoprovide an important confirmatory test in future.

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NMUH Staff Publications

Subdural empyema is an unusual complication ofmeningococcal meningitis, and in acute cases can be rapidly fatal. We present acase of an 8 week old infant who presented with atypical <span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;&#xA;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:&quot;Times New Roman&quot;;&#xA;mso-bidi-theme-font:minor-bidi">Neisseria meningitis with bifrontalsubdural empyema formation. Through the utilisation of modern polymerise chainreaction tests on cerebrospinal fluid samples, we were able to confirm thediagnosis and institute appropriate treatment. Early surgical intervention andappropriate intravenous antibiotics meant that the patient fully recovered. Insummary, early treatment of meningitis without adequate microbiological investigationscan complicate later diagnosis of subdural empyema. Early suspicion of empyemashould be considered when patient fails to improve after 48 hrs, seizures are alate sign and gives a poorer prognosis. Computed tomography scanning is stillthe modality of choice although in this case, magnetic resonance imaging hadits benefits. Polymerase chain reaction of cerebrospinal fluid testing may alsoprovide an important confirmatory test in future.

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