title: Severe Sepsis due to Otogenic Pneumococcal Meningitis with Pneumocephalus without Meningeal Symptoms.
abstract: The absence of meningeal signs and symptoms is rare in patients with bacterial meningitis and may lead to a delay in diagnosis and treatment. Furthermore, the onset of bacterial meningitis associated with pneumocephalus is a rare complication of ear infections. We herein report a rare case of otogenic meningitis complicated by pneumocephalus that was initially missed due to the absence of typical meningeal signs and symptoms and later diagnosed correctly based on a thorough review of the patient's systems.
authors.affiliation: Department of General Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Odani
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Kitazono
authors.forename: Gautam A
authors.initials: GA
authors.lastname: Deshpande
authors.forename: Eiji
authors.initials: E
authors.lastname: Hiraoka
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D003907:Dexamethasone / Q000008:administration & dosage; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis*; D008586:Meningitis, Pneumococcal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D000077731:Meropenem; D011007:Pneumocephalus / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013845:Thienamycins / Q000008:administration & dosage; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014640:Vancomycin; D003907:Dexamethasone; D000077731:Meropenem