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Cerebrospinal fluid leak-associated ventriculitis - a case report

Amir Waheed1, Faryal Amir2

  • 1Department of Acute & General Internal Medicine, Great Western Hospital, Marlborough Road, Swindon SN3 6BB, UK.

Clinical Medicine (London, England)
|December 20, 2024
PubMed

We present a case of a 74-year-old woman with headaches, pyrexia and intermittent right-sided otorrhoea and rhinorrhoea. Her nasal discharge tested positive for beta-2-transferrin, confirming a cerebrospinal fluid (CSF) leak. High-resolution CT (HRCT) mastoids showed a defect in the right tegmen, and CSF within the middle ear and mastoid air cells. A gadolinium-enhanced MRI brain showed high signal in the occipital horns of the lateral ventricles with diffusion-weighted imaging (DWI) and a low signal with DWI-apparent diffusion coefficient (DWI-ADC), consistent with ventriculitis. She made an uneventful recovery after 6 weeks of intravenous antibiotics. The patient had surgical repair of bony defects to prevent recurrence. This highlights a rare case of ventriculitis associated with a spontaneous CSF leak, with no existing set diagnostic criteria, and high mortality. High clinical suspicion aided by appropriate imaging, and a multidisciplinary approach to management are imperative.

Keywords:
Beta-2-transferrinCSF leakCase reportVentriculitis

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