Transethmoidal nasal meningocele and CSF fistula in a child with recurrent bacterial meningoencephalitis

Background Recurrent bacterial meningitis in children poses a considerable diagnostic challenge due to its multiple etiologies. Making an early diagnosis is crucial in preventing further episodes that could lead to a potentially life threatening condition, neurologic sequelae and psychological trauma due to multiple invasive investigations. Recurrent bacterial meningitis has multiple underlying conditions, but it is most frequently caused by anatomic intracranial or lumbosacral defects (encephaloceles, meningocele, temporal bone malformations, skull fracture, dermoid cyst of the lumbosacral spine). Other predisposing conditions are different types of immunodeficiency (immunoglobulin deficiency, complement deficiency, HIV, asplenia) and chronic infections of the middle ear and paranasal sinuses.