Pneumococcal meningitis complicated by otomastoiditis and pneumocephalus confounding an acute ischemic stroke diagnosis

Abstract

Background Approximately one-fourth of admissions to stroke centers are diagnosed with non-stroke conditions or stroke mimics. Differentiating between these diagnoses and acute ischemic stroke is an important and time-sensitive task. The decision of whether or not to administer thrombolytic therapy is also a critical component, and its safety has been studied numerous times. Case Report This case presents a patient with pneumococcal meningitis initially diagnosed as an acute ischemic stroke treated with thrombolytic therapy before further imaging. Conclusion Many stroke mimics such as migraines, infections, and seizures exist. Time is of the essence for the treatment of an acute ischemic stroke. The safety profile of tissue plasminogen activator has been studied numerous times in stroke mimics and shown to be relatively safe indicating if the patient has no contraindications for stroke intervention, treatment of stroke should not be extensively delayed to rule out stroke confounders.

Keywords

• meningitis
• ischemic stroke
• stroke
• cerebrovascular accident
• acute stroke