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Community-Acquired Meningitis Complicated by Pyogenic Ventriculitis: A Case Report
Pabitra Adhikari1, Drashti Antala1, Bimatshu Pyakuryal1
1Internal Medicine, AMITA Health Saint Francis Hospital, Evanston, USA.
Cureus
|May 9, 2022
Summary
Ventriculitis, a brain ventricle inflammation, can present with fever and altered mental status. Prompt antibiotic treatment led to rapid clinical improvement in a patient with Streptococcus pneumoniae infection.
Area of Science:
- Neuroscience
- Infectious Diseases
- Radiology
Background:
- Ventriculitis is brain ventricle inflammation, often a complication of meningitis or surgery.
- Clinical signs include fever, altered mental status, headache, and neck rigidity.
- Common causative agents include Streptococcus, gram-negative bacilli, Staphylococcus, and Meningococcus.
Observation:
- A 57-year-old female presented with fever, headache, and altered mental status.
- Physical exam revealed Kernig's and Brudzinski's signs without focal neurological deficits.
- Cerebrospinal fluid analysis indicated bacterial infection with neutrophilic leukocytosis, high protein, and low glucose.
Findings:
- Blood cultures identified Streptococcus pneumoniae.
- MRI showed fluid-filled layering in ventricles, indicative of pyogenic ventriculitis.
- Meningeal enhancement was notably absent on MRI.
Implications:
- This case highlights Streptococcus pneumoniae as a cause of pyogenic ventriculitis.
- Early empiric antibiotic therapy resulted in rapid clinical improvement.
- The findings underscore the importance of timely diagnosis and treatment for ventriculitis.
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