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Nontraumatic pneumocephalus due to nosocomial Enterobacter cloacae infection

Chin-Chi Kuo1, Jann-Yuan Wang, Jung-Yien Chien

  • 1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Diagnostic Microbiology and Infectious Disease
|May 16, 2009
PubMed

Insights

Nosocomial meningitis, a rare infection, can occur in hospitalized patients with fever and delirium. Early suspicion and cerebrospinal fluid analysis are vital for timely diagnosis and treatment.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Critical Care Medicine

Background:

  • Nosocomial meningitis is an uncommon hospital-acquired infection.
  • Routine cerebrospinal fluid (CSF) analysis is not standard for febrile delirium in inpatients.
  • Enterobacter cloacae is an opportunistic pathogen.

Observation:

  • A case of Enterobacter cloacae meningitis in a hospitalized patient is presented.
  • The meningitis was complicated by spontaneous, nontraumatic pneumocephalus (air in the cranial cavity).
  • The patient exhibited acute delirium, fever, and multiple comorbidities.

Findings:

  • The study highlights a rare presentation of nosocomial meningitis.
  • The complication of nontraumatic pneumocephalus in this context is unusual.
  • Cerebrospinal fluid analysis confirmed Enterobacter cloacae meningitis.

Implications:

  • A high index of suspicion for nosocomial meningitis is crucial in patients with acute delirium, especially those with comorbidities.
  • Prompt CSF studies are essential for diagnosing rare infections like Enterobacter cloacae meningitis.
  • This case underscores the importance of considering uncommon diagnoses in complex hospitalized patients.

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