European Journal of Case Reports in Internal Medicine (Mar 2018)

Cerebral Vasculitis Complicating Pneumococcal Meningitis

  • Ahmed Khedher,
  • Nesrine Sma,
  • Dorsaf Slama,
  • Nesrine Fraj,
  • Wissem Hachfi,
  • Mohamed Boussarsar

DOI
https://doi.org/10.12890/2018_000819
Journal volume & issue
Vol. 5, no. 5

Abstract

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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.

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