2023 Volume 73 Issue 3 Pages 221-224
The number of cases of bacterial meningitis has decreased compared to previous years due to vacccination, but the mortality and sequelae rate are still high even with appropriate treatment. The incidence of the disease is low after school age. We report a rare case of bacterial meningitis caused by acute isolated sphenoid sinusitis in a child. The patient was a 13-years-old girl. One week prior to her visit to our hospital, she developed headache, which did not improve, so she visited her home doctor on the day of her visit. She had worsening headache, paralysis of the extraocular muscles on right side, and leukocytosis and elevated CRP in blood tests. Cerebrospinal fluid (CSF) examination revealed increased cell count with decreased CSF glucose. Head MRI scan showed T2WI high signal in the bilateral sphenoid sinuses, and she was transferred to our hospital for endoscopic sinus surgery. The patient’s symptoms improved with antibiotic therapy, and she was discharged without sequelae on the 21st day after a total of 19 days of intravenous antibiotic therapy. Spinal fluid culture identified Streptococcus intermedius. Clinicians must be aware of intracranial complications such as meningitis by sinusitis.
