Recurrent Streptococcus Pneumoniae 23 F meningitis due to cerebrospinal fluid leakage from the ear cannel: a case report

BMC Pediatrics

Han-Ping Wu⁵  Huang-Tsung Kuo⁴  Kang-Hsi Wu¹  Chun-Yu Chen²  Yu-Cheng Li³ 

[1] Department of Hemato-oncology, Children’s Hospital, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC;School of medicine, Chung Shan Medical University, Taichung, Taiwan, ROC;Department of Pediatrics, Taichung Tzuchi Hospital, the Buddhist Medical Foundation, Taichung, Taiwan, R.O.C;Division of Developmental and Behavioral Pediatrics, Children’s Hospital, China Medical University, Taichung, Taiwan, ROC;College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C

关键词: Cerebrospinal fluid;    Meningitis;    Recurrent;    Streptococcus pneumoniae;   

Others  :  1234512
DOI  :  10.1186/s12887-015-0509-2

 received in 2015-03-16, accepted in 2015-11-14,  发布年份 2015

【 摘 要 】

Background

Bacterial meningitis is a medical emergency, and immediate diagnostic steps must be taken to establish the specific cause. Recurrence of bacterial meningitis in children is not only potentially life-threatening, but also involves or induces psychological trauma to the patients through repeated hospitalization with many invasive investigations.

Case presentation

A 6-year-old boy was diagnosed with recurrent bacterial meningitis caused by Streptococcus Pneumonia 23 F. He had received serial imaging studies for identifying the cause. The initial sinus computed tomography (CT) also showed sinusitis without bony defect of sinus. However, after performing nuclear scan, the results showed cerebrospinal fluid (CSF) leaked originating from the right petrooccpital region into the middle ear. Subsequent high resolution CT (HRCT) reports showed focal enlargement of the right facial nerve canal, erosion of the bony canal at geniculate ganglion and tympanic segment with tiny high-density spots. The reconstruction HRCT showed multiple bony defects at temporal bone. The magnetic resonance imaging revealed multifocal bony destruction with CSF collection in the right petrous ridge, carotid canal and jugular foramen. Eventually, CSF leakage to the right middle ear was confirmed and this could be the cause of the recurrent bacteria meningitis in this patient.

Conclusion

Although recurrent bacterial meningitis in childhood is not common, this case report illustrates that recurrence of meningitis within a short period should be considered as cause of underline immunologic or anatomic defect.

【 授权许可】

   
2015 Li et al.

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