Streptococcal meningitis with an unusual port of entry.
An 18-month-old boy developed meningitis due to group A beta-hemolytic Streptococcus. Despite adequate antibiotic therapy with aqueous sodium penicillin G and chloramphenicol for more than eight weeks, he showed persistent abnormal spinal fluid findings, recurrent elevations of temperature, irritability, and poor feeding. Further investigation revealed a congenital dermal sinus of the nose, with an entry into the anterior fossa that made a small opening intradurally at the level of the cribiform plate. Surgical removal of the entire sinus tract resulted in a speedy and complete recovery.
D005004:Ethmoid Bone / Q000002:abnormalities; D005402:Fistula / Q000151:congenital; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000209:etiology* / Q000382:microbiology; D009668:Nose Diseases / Q000151:congenital; D013290:Streptococcal Infections / Q000209:etiology* / Q000382:microbiology