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Recurrent meningitis: a case report
M Ceccarelli1, M Balestri, C Fontani
1Paediatric Clinic, University of Pisa, Italy.
Abstract:
A 25-month-old girl is described who experienced three successive attacks of purulent meningitis due to Proteus mirabilis. Third generation cephalosporins were employed as treatment. Cranial radiography and computed tomography revealed a malformation, in the form of an epidermoid cyst, in a central occipital position; small cerebellar abscesses were also present. The lesion was removed by surgery which led to a complete recovery.
Insights
A child experienced recurrent Proteus mirabilis meningitis due to an occipital epidermoid cyst. Surgical removal of the cyst led to complete recovery, highlighting the importance of identifying underlying structural causes for pediatric meningitis.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Recurrent bacterial meningitis in children can indicate an underlying structural abnormality.
- Proteus mirabilis is an uncommon but significant pathogen in meningitis, particularly in certain patient populations.
Observation:
- A 25-month-old girl presented with three episodes of purulent meningitis caused by Proteus mirabilis.
- Imaging revealed a central occipital epidermoid cyst and cerebellar abscesses.
Findings:
- The epidermoid cyst was identified as the likely predisposing factor for recurrent Proteus mirabilis meningitis.
- Surgical excision of the epidermoid cyst resulted in complete resolution of meningitis episodes.
Implications:
- Early identification and surgical management of congenital malformations like epidermoid cysts are crucial for preventing recurrent meningitis.
- This case underscores the importance of comprehensive neuroimaging in children with recurrent or unusual bacterial meningitis.