Diffusion magnetic resonance imaging diagnostic relevance in pyogenic ventriculitis with an atypical presentation: a case report

BMC Research Notes

Leonardo Cocito¹  Carlo Trompetto¹  Lucio Marinelli¹ 

[1] Institute of Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Largo Daneo 3, 16132 Genova, Italy

关键词: Corticosteroid theraphy;    Diffusion-weighted magnetic resonance imaging;    Neuroimaging;    Staphylococcus Aureus;    Nosocomial infections;    Pyogenic ventriculitis;   

Others  :  1134277
DOI  :  10.1186/1756-0500-7-149

 received in 2013-10-07, accepted in 2014-03-07,  发布年份 2014

【 摘 要 】

Background

Pyogenic ventriculitis is a rare and severe cerebral infection characterized by the presence of suppurative fluid in the cerebral ventricles. It is a life-threatening condition and may present with an aspecific neurological picture. Brain imaging techniques usually demonstrate intraventricular debris and pus, but negative imaging along with a misleading clinical picture may delay the diagnosis.

Case presentation

The described patient underwent a number of surgical procedures and eventually developed an unusual clinical picture characterized by psychomotor slowing, facial dyskinesias and myoclonic jerks without complaint of headache and in absence of meningeal irritation signs or focal neurological deficits. Cerebrospinal fluid cultural examination showed methicillin-resistant Staphylococcus aureus and vancomycin treatment lead to a complete recovery. Brain computed tomography scan was normal, while only diffusion magnetic resonance imaging sequences were able to define the presence of purulent material within the brain lateral ventriculi.

Conclusion

The present case underlines the importance of taking into account the diagnosis of pyogenic ventriculitis even when the neurological picture does not match the suspect of a central nervous system infection. Moreover, brain computed tomography scan and standard magnetic resonance imaging sequences may be unable to confirm the diagnosis, whereas diffusion-weighted sequences prove a unique role in diagnosing cerebral pyogenic ventriculitis.

【 授权许可】

   
2014 Marinelli et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

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