Journal of Nepal Medical Association (Jul 2023)

Obstructive Infantile Hydrocephalus Secondary to Meningoventriculitis: A Case Report

  • Rupesh Raut,
  • Shailes Paudel,
  • Prakriti Bhandari ,
  • Umang Gupta,
  • Anil Nepali

DOI
https://doi.org/10.31729/jnma.8219
Journal volume & issue
Vol. 61, no. 263

Abstract

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Obstructive infantile hydrocephalus may arise due to anatomic or functional obstruction of cerebrospinal fluid flow. Obstruction of the aqueduct of sylvius (aqueductal stenosis) causes dilation of the lateral and third ventricles, while the size of the fourth ventricle remains relatively normal. Obstructive infantile hydrocephalus with meningoventriculitis is a rare phenomenon, and literature with only 2 other children with similar findings have been reported. We hereby report a case of a 16-week-old infant who developed Escherichia coli meningoventriculitis, later complicated by the development of hydrocephalus, challenging the management. The diagnosis was based on the magnetic resonance imaging of the brain, which showed hydrocephalus, and the cerebrospinal fluid culture showing Escherichia coli meningoventriculitis. The case was managed with serial ventricular drainage along with antibiotics followed by staged ventriculoperitoneal shunting. Serial measurement of head circumference is essential to prompt diagnostic suspicion in the case of paediatric meningitis.

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