Community-Acquired Meningitis Complicated by Pyogenic Ventriculitis: A Case Report

Abstract

Ventriculitis is the inflammation of the ependymal lining of the ventricles in the brain which usually occurs as a complication of meningitis, intraventricular devices, intracranial surgery, or brain abscess. Common clinical features include fever, altered mental status, headache, and neck rigidity. Some commonly associated organisms are Streptococcus, gram-negative Bacillus, Staphylococcus, and Meningococcus. Here, we report the case of a 57-year-old female presenting with fever, headache, and altered mental status, along with positive physical examination findings of Kernig's and Brudzinski's signs without any focal neurological deficits. Cerebrospinal fluid analysis findings were consistent with bacterial infection with neutrophilic leukocytosis, high protein, and low glucose. The blood culture was positive for Streptococcus pneumoniae. Magnetic resonance imaging was negative for enhancement of the meninges but showed fluidfilled layering in the ventricles consistent with pyogenic ventriculitis. The patient improved clinically within three days of initiation of empiric antibiotics.

Community-Acquired Meningitis Complicated With Pyogenic Ventriculitis and Hydrocephalus in a Patient With Haematological Malignancy: A Case Report and Literature Review

“…Kong et al reported that heparin-binding protein (HBP), released from activated neutrophils, displayed greater diagnostic accuracy compared to lactate and procalcitonin, with levels remaining elevated (greater than 23 ng/mL) even in patients treated with antimicrobials for more than 48 hours. This is identified as a reliable adjunctive diagnostic marker [ 11 ].…”

Acute meningitis complicated with ventriculitis caused by Streptococcus dysgalactiae subsp. Dysgalactiae

“…Ventriculitis most commonly occurs as a complication of external ventricular drains or in patients with ventricular shunts. Only a few cases of primary ventriculitis have been reported associated with community-acquired bacterial meningitis [ 11 - 13 ]. Pathological studies of patients who died from bacterial meningitis have shown that the ventricular fluid usually turned cloudy by the end of the first week of the infection.…”