An Unusual Case of Bacterial Meningitis

Abstract

Bacterial meningitis is a medical emergency that requires prompt identification and treatment in the emergency department (ED). Medical management is the mainstay of treatment. However, some patients may require neurosurgical intervention. Furthermore, neurological complications may develop, causing significant morbidity and mortality. We present a case report of a 42-year-old Chinese gentleman who presented to the ED and was subsequently diagnosed with pneumococcal meningitis. In addition to routine medical management, he also underwent emergent extraventricular drainage procedure to alleviate increased intracranial pressure. He subsequently developed stroke, seizure and sensorineural hearing loss. Not seizure-related hearing loss. After a comprehensive rehabilitation program, he showed good response and recovered without focal neurological deficit. A high index of suspicion and timely interventions in ED are important in minimizing morbidity and mortality from bacterial meningitis. The help of neurosurgeons may be necessary in selected cases. Dexamethasone has an important role in the prevention of neurological complications, as well as in their treatment.

Keywords

• Emergency department
• meningitis
• neurosurgical procedure