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Recurrent meningitis due to pneumococci and non-typable Haemophilus influenzae in a child with a Mondini malformation

P Valmari, A Palva

    Infection
    |January 1, 1986
    PubMed

    Insights

    Recurrent meningitis in a child was linked to an inner ear defect causing a cerebrospinal fluid (CSF) fistula. Surgical closure of the fistula resolved the meningitis, highlighting the importance of advanced imaging for diagnosis.

    Area of Science:

    • Otolaryngology
    • Pediatric Neurology
    • Infectious Diseases

    Background:

    • Recurrent meningitis poses diagnostic challenges, particularly in pediatric cases with congenital anomalies.
    • Inner ear malformations can predispose individuals to central nervous system infections.

    Observation:

    • An eight-year-old boy experienced three episodes of bacterial meningitis within seven months.
    • Causative agents included Streptococcus pneumoniae and non-typable Haemophilus influenzae.
    • Episodes presented with abrupt onset, and cerebrospinal fluid (CSF) cultures turned positive rapidly.

    Findings:

    • Despite initial diagnostic ambiguity, surgical exploration revealed a cerebrospinal fluid (CSF) fistula associated with a congenital inner ear malformation.
    • Closure of the CSF fistula successfully prevented further meningitis episodes.

    Implications:

    • Advanced imaging techniques, such as specialized computed tomography (CT) scans, are crucial for diagnosing CSF fistulas in recurrent meningitis.
    • Consideration of CSF fistulas should extend beyond the first meningitis episode, especially with rapid onset and common bacterial pathogens.

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