Meningitis complicated by mycotic aneurysms

Mycotic aneurysms complicated by vasospasm and strokes represent a rare manifestation of bacterial meningitis. We describe a healthy woman diagnosed with bacterial meningitis and mycotic aneurysms, who received both antibiotic and corticosteroid therapy. This approach fostered a significant radiologic improvement in her mycotic aneurysms as evidenced by serial angiographic examinations. During her course, she developed vasospasm and strokes and required intra-arterial verapamil. More importantly and as a result of these combined therapies, the patient experienced a substantial clinical improvement. This case allows the description of mycotic aneurysms epidemiology, clinical presentation and complications. In addition, our vignette bestows the relevance of serial neurologic examinations and radiologic testing during the acute vasculopathy period. Current conservative and interventional therapeutic options are briefly discussed.