Pinilla-Monsalve Gabriel D, Torres-Cutiva Daniel F, Fernández-Cubillos Juan P
Facultad de Ciencias de la Salud, Icesi University, Calle 18 No. 122-135, Cali 760032, Colombia.
Department of Neurology, Fundación Valle del Lili, Cra. 98 No. 18-49, Cali 760032, Colombia.
Infect Dis Rep. 2020 Nov 21;12(3):87-96. doi: 10.3390/idr12030018.
Bacterial meningitis is an infectious pathology that remains a public health challenge. The most frequent etiological agent is , which is also associated with higher rates of mortality and sequels. However, less is known about the clinical presentation of atypical non- streptococcal meningitis. Here, we studied a 23-year-old man with no medical background who presented with projectile vomiting, states of consciousness alteration, unilateral cranial nerve palsy, and meningeal signs. Neuroimaging showed tonsillar herniation, regions of empyema, right transverse and sigmoid sinuses thrombosis, and multiple arterial subcortical infarcts. Cerebrospinal fluid suggested bacterial infection; blood and abscess cultures were positive for The patient received antibiotics with no clinical improvement. He deteriorated over the following days, the abolishment of brainstem reflexes was observed, and brain death was declared. Streptococcal meningitis produced by atypical species is a potential cause of lethal cerebrovascular complications, even in immunocompetent patients.
细菌性脑膜炎是一种感染性疾病，仍然是一项公共卫生挑战。最常见的病原体是 ，它也与较高的死亡率和后遗症发生率相关。然而，对于非典型非链球菌性脑膜炎的临床表现了解较少。在此，我们研究了一名23岁无医学背景的男性患者，他出现了喷射性呕吐、意识状态改变、单侧颅神经麻痹和脑膜刺激征。神经影像学检查显示扁桃体疝、脓胸区域、右侧横窦和乙状窦血栓形成以及多个动脉性皮质下梗死。脑脊液提示细菌感染；血液和脓肿培养 呈阳性。患者接受了抗生素治疗，但临床症状无改善。在接下来的几天里他病情恶化，观察到脑干反射消失，并宣布脑死亡。由非典型菌种引起的链球菌性脑膜炎是导致致命性脑血管并发症的一个潜在原因，即使在免疫功能正常的患者中也是如此。
