Abstract
From 2010 through 2012, we have treated three cases of bacterial meningitis associated with cervical pyogenic spondylitis. Each patients had been diagnosed with underlying disease such as primary splenic malignant lymphoma, mesopharyngeal carcinoma or diabetes mellitus. All presented with neck pain and high fever. This neck pain was also observed during neck rotation, affecting difficulty in differentiation with neck stiffness. Cerebrospinal fluid examination revealed pleocytosis with a low glucose level. T2 weighted images obtained from cervical spine magnetic resonance imaging revealed pyogenic spondylitis in all patients, and a high signal retropharyngeal abscess in two cases. In two cases, blood culture detected Streptococcus pnemoniae (one case each of penicillin-resistant and penicillin-susceptible strains). Antibiotic treatment was administered until the inflammatory reaction resolved on laboratory data. After treatment, neurological symptoms and neck pain gradually improved. When bacterial meningitis presents with atypical neck pain, it is necessary to consider the association with cervical pyogenic spondylitis.
