Spontaneous esophageal perforation presenting as meningitis

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Published on: July 14, 2020

Carlo C Jurani1, Gerald L Early, Shauna R Roberts

  • 1Department of General Surgery, University of Kansas, Kansas City 66160-7119, USA.

The Annals of Thoracic Surgery
|May 9, 2002
PubMed

Insights

This case study highlights spontaneous esophageal perforation, a rare cause of meningitis. Prompt surgical intervention led to successful patient recovery despite diagnostic delays.

Area of Science:

  • Gastroenterology
  • Neurology
  • Infectious Diseases

Background:

  • Boerhaave's syndrome, or spontaneous esophageal perforation, is a rare but life-threatening condition.
  • Central nervous system infections secondary to esophageal perforation are infrequently reported, often linked to instrumentation, trauma, or malignancy.

Observation:

  • A patient presented with symptoms mimicking meningitis.
  • A significant delay in diagnosis (16 days) occurred due to the unusual presentation.

Findings:

  • The patient was diagnosed with spontaneous esophageal perforation presenting as meningitis.
  • Successful treatment involved debridement, primary closure, and drainage of the affected area.

Implications:

  • This case underscores the importance of considering esophageal perforation in the differential diagnosis of meningitis, even in the absence of typical risk factors.
  • Early recognition and intervention are crucial for favorable outcomes in Boerhaave's syndrome with central nervous system involvement.

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