Cerebral Vasculitis Complicating Pneumococcal Meningitis
  • Ahmed Khedher
    Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia
  • Nesrine Sma
    Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia
  • Dorsaf Slama
    Infectious Diseases Department, Farhat Hached Hospital, Sousse, Tunisia
  • Nesrine Fraj
    Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia
  • Wissem Hachfi
    Infectious Diseases Department, Farhat Hached Hospital, Sousse, Tunisia
  • Mohamed Boussarsar
    Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia

Keywords

Cerebral vasculitis, pneumococcal meningitis, stroke, steroids

Abstract

Introduction: Cerebral vasculitis is an uncommon life-threatening complication of community-acquired bacterial meningitis.

Patient and methods: We report the case of a 64-year-old woman with pneumococcal meningitis who developed parainfectious vasculitis causing ischaemic brain damage. Cerebral magnetic resonance imaging (MRI) confirmed the diagnosis. Clinical and radiological recovery after delayed addition of corticosteroid was achieved.

Discussion: This report shows that the onset of neurological deficits following pneumococcal meningitis can be caused by cerebral vasculitis. Underdosing with antibiotics and delayed adjunctive dexamethasone seem to favour this complication. There are no guidelines for treatment but high doses of steroids led to resolution in this case.

VIEW THE ENTIRE ARTICLE

References

  • Regaieg K, Baccouche N, Souissi B, Bahloul M, Bouaziz M. Vascularite cérébrale: une complication rare de la méningite à Streptococcus pneumoniae. Med Mal Infect 2016;46:3.

  • Klobassa DS, Zoehrer B, Paulke-Korinek M, Gruber-Sedlmayr U, Pfurtscheller K, Strenger V, et al. The burden of pneumococcal meningitis in austrian children between 2001 and 2008. Eur J Pediatr 2014;173:871–878.

  • Tavladaki T, Spanaki AM, llia S, Geromarkaki E, Raissaki M, Briassoulis G. Unusual exanthema combined with cerebral vasculitis in pneumococcal meningitis: a case report. J Med Case Report 2011;5:410.

  • Schut ES, Brouwer MC, de Gans J, Florquin S, Troost D, van de Beek D. Delayed cerebral thrombosis after initial good recovery from pneumococcal meningitis. Neurology 2009;73:1988–1995.

  • Société de Pathologie Infectieuse de Langue Française. Management of acute community-acquired bacterial meningitides, except in newborn infants. Rev Neurol (Paris) 2009;165:205–16.

  • de Gans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med 2002;347:1549–1556.

    • Views: 2879
    HTML downloads: 215
    PDF downloads: 1537

    Published: 2018-03-13
    Issue: Vol. 5 No. 5 (view)

    How to cite:
    1.
    Khedher A, Sma N, Slama D, Fraj N, Hachfi W, Boussarsar M. Cerebral Vasculitis Complicating Pneumococcal Meningitis. EJCRIM 2018;5 doi:10.12890/2018_000819.