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Viridans streptococcal meningitis following penetrating cervical injury

Joseph B Cantey1, Pranita Tamma

  • 1Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA. jbcantey@gmail.com

Pediatric Emergency Care
|January 6, 2011
PubMed

Insights

This case report details Streptococcus salivarius meningitis in a child following neck trauma. It emphasizes the risk of meningitis with cerebrospinal fluid leaks and unrecognized pneumocephalus.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Viridans streptococcal meningitis is uncommon, typically linked to medical procedures or weakened immune systems.
  • Streptococcus salivarius is a rare cause of meningitis, especially in otherwise healthy individuals.

Observation:

  • A healthy child developed meningitis after neck lacerations from a fall onto a drinking glass.
  • Initial presentation was deceptive, with pneumocephalus on CT scan initially missed.
  • The patient returned within 24 hours with symptoms of meningismus (stiff neck).

Findings:

  • The case demonstrates meningitis caused by Streptococcus salivarius following penetrating neck trauma.
  • Pneumocephalus, a sign of potential cerebrospinal fluid leak, was a critical but initially unrecognized finding.
  • Cerebrospinal fluid leaks significantly increase the risk of meningitis.

Implications:

  • Highlights the importance of recognizing radiographic signs of traumatic fistulas, such as pneumocephalus.
  • Underscores the heightened risk of meningitis in patients with cerebrospinal fluid leaks.
  • This is the first reported instance of viridans streptococcal meningitis secondary to penetrating neck trauma.

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