title: Surgically Cured, Relapsed Pneumococcal Meningitis Due to Bone Defects, Non-invasively Identified by Three-dimensional Multi-detector Computed Tomography.
abstract: A 43-year-old Japanese man presented with a history of bacterial meningitis (BM). He was admitted to our department with a one-day history of headache and was diagnosed with relapse of BM based on the cerebrospinal fluid findings. The conventional imaging studies showed serial findings suggesting left otitis media, a temporal cephalocele, and meningitis. Three-dimensional multi-detector computed tomography (3D-MDCT) showed left petrous bone defects caused by the otitis media, and curative surgical treatment was performed. Skull bone structural abnormalities should be considered a cause of relapsed BM. 3D-MDCT was useful for revealing the causal minimal bone abnormality and performing pre-surgical mapping.
authors.affiliation: Division of Neurology, Department of Medicine, Nihon University School of Medicine, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Akimoto
authors.forename: Akihiko
authors.initials: A
authors.lastname: Morita
authors.forename: Keiji
authors.initials: K
authors.lastname: Shiobara
authors.forename: Makoto
authors.initials: M
authors.lastname: Hara
authors.forename: Masayuki
authors.initials: M
authors.lastname: Minami
authors.forename: Katsunori
authors.initials: K
authors.lastname: Shijo
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nomura
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Shigihara
authors.forename: Hiroki
authors.initials: H
authors.lastname: Haradome
authors.forename: Osamu
authors.initials: O
authors.lastname: Abe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kamei
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D010033:Otitis Media / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D010579:Petrous Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D012008:Recurrence; D012293:Rifampin / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D012293:Rifampin