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Delayed CSF rhinorrhea presenting as a lethal acute bacterial meningitis 5 years post trauma

Bipin Karki1, Utsav Acharya2, Bishika Pun3

  • 1Department of Critical Care Medicine, Maharajgunj Medical Campus Institute of Medicine Kathmandu Nepal.

Clinical Case Reports
|May 14, 2023
PubMed

Insights

Delayed cerebrospinal fluid (CSF) leak after head trauma can lead to meningitis and fatal outcomes if not promptly managed. This case underscores the critical need for timely diagnosis and intervention for CSF rhinorrhea.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Trauma Surgery

Background:

  • Cerebrospinal fluid (CSF) rhinorrhea following head trauma is a rare but serious condition.
  • Delayed diagnosis and management of CSF leaks can lead to severe complications, including meningitis.

Observation:

  • A 33-year-old male presented with Streptococcus pneumoniae meningitis and septic shock.
  • He had a history of severe traumatic brain injury 5 years prior and intermittent nasal discharge for 1 year.
  • CT scan revealed cribriform plate defects, confirming CSF rhinorrhea.

Findings:

  • The patient was diagnosed with meningoencephalitis secondary to untreated cerebrospinal fluid rhinorrhea.
  • Despite appropriate antibiotic treatment, the patient did not survive.

Implications:

  • This case highlights the critical importance of recognizing and managing delayed cerebrospinal fluid rhinorrhea after head trauma.
  • Untreated CSF leaks pose a significant risk of fatal meningitis, emphasizing the need for prompt surgical or conservative management.
  • Timely intervention is crucial to prevent life-threatening complications and improve patient outcomes in cases of traumatic brain injury.
Keywords:
CSF rhinorrheameningoencephalitisseptic shock

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