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Published on: October 14, 2022
Community-Acquired Meningitis Complicated With Pyogenic Ventriculitis and Hydrocephalus in a Patient With
Anosh Aslam Khan1, Muhammad Saad Anwar1, Phani Bhavana Cherukuri1
1Department of Internal Medicine, Monmouth Medical Center, Long Branch, USA.
Abstract:
Meningitis, an infection of the meninges of the central nervous system (CNS), can advance quickly and carries a mortality rate reaching 30% among affected patients. It may become complicated by conditions such as hydrocephalus, ventriculitis, and cerebral abscess. Here, we describe a case of meningitis that was complicated by pyogenic ventriculitis and hydrocephalus in a patient with diffuse large B-cell lymphoma (DLBCL) who underwent chemotherapy and radiotherapy. The patient presented with acute change in mental status and high-grade fever, with few episodes of non-bloody vomiting. Blood culture and cerebrospinal fluid (CSF) culture grew Streptococcus pneumoniae, which was sensitive to ceftriaxone. CT scan of the head showed ventriculomegaly, pansinusitis, and a large left mastoid effusion. MRI of the brain showed layering in ventricles, hydrocephalus, and dural enhancement consistent with pachymeningitis. She was treated with ceftriaxone for 21 days with a meaningful outcome. She was discharged home with near-baseline mental capacity for further physical therapy.
Insights
This case study details meningitis complicated by ventriculitis and hydrocephalus in a patient with diffuse large B-cell lymphoma. Prompt treatment with ceftriaxone led to a positive outcome, with near-baseline mental recovery.
Area of Science:
- Neuroscience
- Infectious Diseases
- Oncology
Background:
- Meningitis, a central nervous system infection, has a high mortality rate and can lead to severe complications.
- Complications include hydrocephalus, ventriculitis, and cerebral abscesses, significantly increasing patient risk.
- Diffuse large B-cell lymphoma (DLBCL) patients undergoing chemotherapy and radiotherapy are particularly vulnerable to opportunistic infections.
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