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