title: Bacterial meningitis: a rare complication of an unrecognised nasal foreign body in a child.
abstract: We present an interesting case of a 7-year-old child who developed severe bacterial meningitis requiring admission to paediatric ICU. Initial investigations failed to identify the reason for this otherwise healthy child to develop this life-threatening condition. The child recovered fully with no long-term sequelae. Further on-going unilateral purulent rhinorrhoea lead to ENT referral. CT head from a previous admission showed mucosal thickening and fluid within paranasal sinuses. Reluctance to expose the child to further radiation meant that no formal scan of sinuses was organised and the child was diagnosed with chronic rhinosinusitis. Symptoms failed to improve despite the treatment. A subsequent CT scan of sinuses revealed a radiopaque foreign body in the nasal cavity. This is a rare presentation of a nasal foreign body causing bacterial meningitis. This case highlights the importance of comprehensive investigations to avoid delays in establishing a correct diagnosis and initiating the appropriate treatment.
authors.affiliation: Otolaryngology and Head and Neck Surgery, Royal Surrey County Hospital, Guildford, UK.
authors.forename: Jana
authors.initials: J
authors.lastname: van der Veen
authors.affiliation: Otolaryngology and Head and Neck Surgery, Royal Surrey County Hospital, Guildford, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Thorne
mesh_terms: D002648:Child; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008443:Maxillary Sinus / Q000000981:diagnostic imaging*; D008586:Meningitis, Pneumococcal / Q000209:etiology*; D009666:Nose / Q000000981:diagnostic imaging*; D012220:Rhinitis / Q000000981:diagnostic imaging / Q000209:etiology; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed