Related Experiment Video

Updated: Jan 25, 2026

Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
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Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation

Published on: February 29, 2020

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[A case of chordoma presenting as recurrent bacterial meningitis with cerebrospinal fluid leakage]

Shoichiro Ando1, Hiroyuki Usuda2, Yoshitaka Umeda1

  • 1Department of Neurology, Nagaoka Red Cross Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|May 8, 2019
PubMed

Insights

Recurrent bacterial meningitis in a 52-year-old man was linked to a rare clival bone defect caused by chordoma. Prompt diagnosis involving CSF rhinorrhea assessment is crucial for identifying the infection source.

Area of Science:

  • Neurosurgery
  • Neurology
  • Pathology

Background:

  • Recurrent bacterial meningitis presents a diagnostic challenge, especially when initial cultures are negative.
  • Cerebrospinal fluid (CSF) analysis can indicate inflammation but may not reveal the underlying cause.
  • Identifying subtle anatomical defects is key to managing unexplained infections.

Observation:

  • A 52-year-old male experienced two meningitis episodes within six months.
  • Cerebrospinal fluid showed inflammation, but cultures were negative.
  • The patient presented with intermittent cerebrospinal fluid (CSF) rhinorrhea during the second admission.

Findings:

  • Imaging revealed a small clival bone defect.
  • Pathological diagnosis confirmed chordoma via immunohistochemical staining for brachyury.
  • Transnasal endoscopic repair of the defect was successful.

Implications:

  • Chordoma can manifest unusually as recurrent meningitis, a rare presentation.
  • Thorough patient history, including questioning about CSF rhinorrhea, is vital for diagnosing obscure meningitis.
  • Early detection and surgical intervention for bone defects can prevent recurrent infections.
Keywords:
MR cisternographycerebrospinal fluid leakschordomarecurrent bacterial meningitis

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