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Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Meningitis complicated by mycotic aneurysms.

Ciro Ramos-Estebanez1, Dileep Yavagal2

  • 1Department of Neurology, Neurocritical Care Division, Cleveland, OH 44106-1716 , USA.

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Summary

This case study highlights a successful treatment for mycotic aneurysms complicating bacterial meningitis, showing significant improvement with antibiotics, corticosteroids, and intra-arterial verapamil for vasospasm.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Mycotic aneurysms are rare but serious complications of bacterial meningitis.
  • Vasospasm and strokes can further complicate these cases, posing significant clinical challenges.

Observation:

  • A healthy woman with bacterial meningitis developed mycotic aneurysms, vasospasm, and strokes.
  • She was treated with antibiotics, corticosteroids, and intra-arterial verapamil.

Findings:

  • Combined antibiotic and corticosteroid therapy led to significant radiologic improvement of mycotic aneurysms.
  • Intra-arterial verapamil managed vasospasm and strokes.
  • The patient experienced substantial overall clinical improvement.

Implications:

  • This case underscores the importance of aggressive management for mycotic aneurysms and associated vasculopathy.
  • Serial neurologic examinations and advanced imaging are crucial for monitoring during the acute phase.
  • A combined therapeutic approach may be highly effective in improving outcomes for this rare condition.