Cerebrospinal fluid rhinorrhoea and Haemophilus influenzae meningitis 37 years after a head injury.

Bacterial meningitis secondary to CSF rhinorrhoea is well recognised. We present a case of meningitis due to Haemophilus influenzae type b associated with a CSF fistula. The patient was 40 years of age at presentation, having sustained a head injury when 3-years-old. He had suffered intermittent rhinorrhoea for 18 months before admission. Delays between head injury and meningitis are well recognised, but our case may represent the longest recorded interval. H. influenzae meningitis in adults is discussed.