A 34-year-old woman presented initially with meningococcal meningitis and with Streptococcus mitis meningitis 6 months later. A right cribriform plate area meningoencephalocele was discovered on MRI at the second episode. In retrospect, this abnormality was present on initial MRI (figure). The patient recalled intermittent watery rhinorrhea for 1 year preceding the first meningitis episode, but...

The CDC presented considerations for distinguishing influenza-like illness from inhalational anthrax (MMWR, 9 Nov 01, 50:44 pp. 984-986). “Although many different illness might present with influenza-like illnesses (ILI) symptoms, the presence of certain signs and symptoms might help to distinguish other causes of ILI from inhalational anthrax. Nasal congestion and rhinorrhea are features of mo...

UNLABELLED Therapeutic shrinkage of prolactinomas with dopamine agonists achieves clinical benefit but can expose fistulae that have arisen as a result of bony erosion of the sella floor and anterior skull base by the invasive tumour, resulting in the potential development of cerebrospinal fluid (CSF) rhinorrhoea, meningitis, and rarely pneumocephalus. Onset of symptoms is typically within 4 mo...

Recurrence of bacterial meningitis in children is not only potentially life-threatening, but also involves or induces psychological trauma to the patients through repeated hospitalization and multiple invasive investigations if the underlying cause remains undetected. Bacteria migration, along congenital or acquired pathways from the skull or spinal dural defects, gains entrance into the centra...