Diagnostic Dilemma in a 15-Year-Old Boy with Recurrent Pneumococcal Meningitis SD03-SD04
Dr. Aniruddha Ghosh,
Institute of Child Health, Kolkata Male PGT Quarters, Room No-7 MRI Building 3rd Floor-11,
Dr. Biresh Guha Street, Kolkata-700017, West Bengal, India.
Recurrent bacterial meningitis is very rare phenomenon in paediatric age group. Finding the aetiology of recurrent meningitis often poses diagnostic challenge to clinicians. Among the several aetiologies, structural deficiencies at the base of skull, congenital or acquired, are readily correctable ones and hence itâ€™s imperative to find out the location of the gap in order to surgically repair it. We report the diagnostic dilemma faced while managing a 15-year-old boy with recurrent pneumococcal meningitis. Aetiology could only be found after exclusion of immunodeficiency and performing a series of imaging studies. CT cisternogram clinched the diagnosis and patient was cured successfully. A single imaging modality, be it CT/MRI scan, although proven to be better than others according to literature, might not be sufficient while finding the cause of recurrent bacterial meningitis in an immunocompetent host.