Anandi Shobi, Tullu Milind S, Bhatia Sonal, Agrawal Mukesh
Department of Pediatrics, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Mumbai 400012, Maharashtra, India.
J Child Neurol. 2012 Aug;27(8):1052-5. doi: 10.1177/0883073811430766. Epub 2012 Jan 30.
Mondini dysplasia is a rare but an important cause for recurrent pyogenic meningitis in children and requires a high index of clinical suspicion for early diagnosis. We present the case of a 7-year-old boy, who presented with 2 episodes of pyogenic meningitis within a span of 1 month. There was no obvious history of hearing abnormalities, but pure tone audiometry suggested profound mixed hearing loss in the left ear. High-resolution computed tomographic scan and magnetic resonance imaging of temporal bones confirmed the diagnosis of Mondini dysplasia in the left ear. Computed tomographic cisternography failed to demonstrate any obvious cerebrospinal fluid leak. The child was managed conservatively and has been asymptomatic since then. Thus, in our patient, Mondini dysplasia as a cause for recurrent pyogenic meningitis was diagnosed (early) during the second episode of meningitis. The need for an early diagnosis of Mondini dysplasia has been stressed in this report.
Mondini发育异常是儿童复发性化脓性脑膜炎的罕见但重要病因,早期诊断需要高度的临床怀疑指数。我们报告一例7岁男孩,在1个月内出现2次化脓性脑膜炎发作。无明显听力异常病史,但纯音听力测定提示左耳重度混合性听力损失。颞骨高分辨率计算机断层扫描和磁共振成像确诊左耳Mondini发育异常。计算机断层脑池造影未显示任何明显的脑脊液漏。该患儿接受保守治疗,此后一直无症状。因此,在我们的患者中,Mondini发育异常作为复发性化脓性脑膜炎的病因在第二次脑膜炎发作时(早期)被诊断出来。本报告强调了早期诊断Mondini发育异常的必要性。