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Case Report
Recurrent bacterial meningitis with cerebrospinal fluid rhinorrhea
1 Dr.Med.Sc. (General Medicine), Consultant Endocrinologist at Grand Hantha International Hospital and Professor Emeritus at University of Medicine 2, Yangon, Myanmar
2 Dr.Med.Sc. (Neurology), Consultant Neurologist, Grand Hantha International Hospital, Yangon, Myanmar
3 M.Med.Sc. (Internal Medicine), Independent Researcher, Yangon, Myanmar
Address correspondence to:
Than Than Aye
London Clinic, Grand Hantha InterHospital, No. 3, Corner of Nan Nat Taw Road and Ahlone Kanar Road, Kamaryut Township, Yangon,
Myanmar
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Article ID: 101362Z01TA2022
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Aye TT, Sann AA, Tun HP. Recurrent bacterial meningitis with cerebrospinal fluid rhinorrhea. Int J Case Rep Images 2022;13(2):210–214.ABSTRACT
Introduction: Recurrent bacterial meningitis is a rare clinical phenomenon, but a telltale sign of a mysterious foe. It is an occurrence of two or more episodes of bacterial meningitis by different organisms, or with the same organism and the episodes separated by an interval of at least three weeks.
Case Report: We present a case of a 29-year-old gentleman who presented with acute pyogenic meningitis due to Streptococcus pneumoniae. This is the second episode of confirmed bacterial meningitis in two years with another episode of meningitis ten years ago, which was treated as tuberculous. History of rhinorrhea was elicited on direct questioning and cerebrospinal fluid leak through cribriform plate was confirmed on magnetic resonance imaging. The current episode of meningitis was successfully treated with intravenous high dose cephalosporin and short course dexamethasone. The patient was referred to a neurosurgeon for closure of cerebrospinal fluid leak.
Conclusion: This case highlights the importance of a thorough clinical history and awareness of a seemingly unimportant symptom which can be an important diagnostic clue.
Keywords: Cerebrospinal fluid rhinorrhea, Cribriform plate defect, Pneumococcal meningitis, Recurrent meningitis
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Author Contributions
Than Than Aye - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Aye Aye Sann - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Hpone Pyae Tun - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Than Than Aye et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
