Lee Sorae, Kim Sumin, Sunwoo Jun-Sang
Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea.
Encephalitis. 2023 Oct;3(4):125-128. doi: 10.47936/encephalitis.2023.00164. Epub 2023 Sep 25.
Pneumocephalus refers to a pathologic collection of gas within the cranial cavity and is mostly caused by head trauma and neurosurgical procedures. Spontaneous nontraumatic pneumocephalus is a very rare condition. We herein report an unusual case of community-acquired bacterial meningitis with a combination of acute otitis media, Enterobacter cloacae, and nontraumatic pneumocephalus. A 75-year-old woman presented with fever, mental change, and neck stiffness. Brain imaging demonstrated pneumocephalus and fluid collection in the left mastoid air cells. E. cloacae was isolated from both blood and otorrhea cultures, and the patient was successfully treated with intravenous ceftazidime for 3 weeks. Although E. cloacae is a very rare cause of community-acquired bacterial meningitis in adults, it should be considered as a possible pathogen in otogenic meningitis complicated with pneumocephalus.
气颅是指颅腔内气体的病理性积聚，主要由头部外伤和神经外科手术引起。自发性非创伤性气颅是一种非常罕见的情况。我们在此报告一例不寻常的社区获得性细菌性脑膜炎病例，合并急性中耳炎、阴沟肠杆菌感染和非创伤性气颅。一名75岁女性出现发热、精神改变和颈部僵硬。脑部影像学检查显示气颅和左侧乳突气房积液。血液和耳漏培养均分离出阴沟肠杆菌，患者接受静脉注射头孢他啶治疗3周后成功治愈。尽管阴沟肠杆菌是成人社区获得性细菌性脑膜炎非常罕见的病因，但在并发气颅的耳源性脑膜炎中应将其视为可能的病原体。
