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Haemophilus influenzae meningitis in an adult with initially normal cerebrospinal fluid
1Department of Medicine, University of Missouri-Kansas City, School of Medicine 64108-2792.
Abstract:
We have described an adult patient with signs and symptoms of bacterial meningitis who had an initially unremarkable cerebrospinal fluid examination, but then had development of fulminant meningitis over the next 48 hours. Bacterial meningitis with normal CSF values has been previously reported in children, immunocompromised hosts, and alcoholics, and in patients with fulminant infections due to Neisseria meningitidis. We recommend that all patients with signs and symptoms compatible with bacterial meningitis and with normal results of CSF examination have close follow-up clinically over the next 48 hours with consideration of repeating the lumbar puncture.
Insights
Bacterial meningitis can present with normal cerebrospinal fluid (CSF) initially, even in adults. Close clinical follow-up and repeat lumbar puncture are crucial for patients with suspected meningitis and unremarkable CSF findings.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Medicine
Background:
- Bacterial meningitis is a serious infection of the membranes surrounding the brain and spinal cord.
- Cerebrospinal fluid (CSF) analysis is a primary diagnostic tool for meningitis.
- Normal CSF findings in the initial examination can occur, posing diagnostic challenges.