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[Chronic meningococcal meningitis in an adult]

R Ursu1, D Voillery, N Valin

  • 1Service de neurologie Mazarin, groupe hospitalier Pitié-Salpêtrière, 47-94, boulevard de l'Hôpital, 75013 Paris, France. renata.ursu@yahoo.fr

Revue Neurologique
|October 28, 2008
PubMed

Insights

This case study highlights a rare instance of chronic Neisseria meningitidis meningitis. Prompt treatment led to dramatic improvement, underscoring the importance of considering unusual pathogens in prolonged neurological disorders.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Chronic meningitis can present with subtle, non-specific symptoms, mimicking psychiatric disorders.
  • Neisseria meningitidis is a common cause of acute bacterial meningitis, but rarely presents chronically.

Observation:

  • A 46-year-old woman presented with a four-month history of progressive cognitive and behavioral changes.
  • Cerebrospinal fluid analysis revealed a purulent meningitis with elevated protein and low glucose, but initial cultures were negative.
  • Magnetic Resonance Imaging (MRI) showed hydrocephalus and meningeal enhancement.

Findings:

  • Cerebrospinal fluid cultures, after nine days, identified Neisseria meningitidis group B.
  • The patient received high-dose intravenous cefotaxime and anti-tuberculous treatment, leading to significant clinical improvement.

Implications:

  • This case emphasizes the importance of considering atypical presentations of Neisseria meningitidis meningitis, especially in chronic or subacute forms.
  • Early and appropriate antibiotic therapy is crucial for favorable outcomes in rare chronic bacterial meningitis cases.
  • The diagnostic challenge posed by N. meningitidis meningitis necessitates a high index of suspicion for unusual presentations.

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