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Late posttraumatic meningitis with concealed CSF otorrhea
1Department of Surgery, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
Insights
Recurrent pneumococcal meningitis in a child was successfully treated by surgically repairing a petrous bone fracture. This case highlights the need for thorough skull base evaluation in late post-traumatic infections.
Area of Science:
- Neurology
- Neurosurgery
- Otolaryngology
Background:
- Recurrent meningitis poses significant challenges, particularly in pediatric cases.
- Head trauma can lead to complex complications, including cerebrospinal fluid leaks.
Observation:
- An 11-year-old girl experienced recurrent pneumococcal meningitis following a head injury.
- Imaging revealed a petrous bone fracture with a cerebrospinal fluid collection in the middle ear.
Findings:
- High-resolution CT with metrizamide cisternography identified a fracture in the petrous bone.
- Surgical repair of the dural defect effectively resolved the intracranial infections.
Implications:
- This case underscores the importance of aggressive skull base assessment in late post-traumatic infections.
- Early diagnosis and surgical intervention are crucial for managing traumatic cerebrospinal fluid leaks and preventing meningitis.
Abstract:
An 11-year-old girl with repeated pneumococcal meningitis after head injury is reported. High resolution CT scan with metrizamide cisternogram disclosed a fracture in petrous bone with collection of contrast medium in middle ear. Operative repair of the dura defect successfully stopped further intracranial infection. In cases of late posttraumatic infection, aggressive survey of the skull base is indicated.